BACKGROUND Children and young people with long-term conditions (LTCs) are usually dependent on, or share management with, their families and are expected to develop self-management skills as they mature. However, during adolescence, young people can find it challenging to follow prescribed treatment regimens resulting in poor clinical outcomes. Though reviews have looked at children's and parents' experiences of self-management, none have explicitly examined the parent-to-child transfer of self-management responsibility. METHODS An integrative review was conducted with the aim of exploring the parent-to-child transfer of LTC self-management responsibility, through addressing two questions: (a) How do children assume responsibility from their parents for self-management of their LTC? (b) What influences the parent-to-child transfer of this responsibility? Eight databases were searched for papers published from 1995 to 2017. Methodological quality was assessed; included papers were synthesized to identify themes. RESULTS Twenty-nine papers were identified. Most papers used qualitative designs and focused on children with diabetes. Participants were predominantly children and/or parents; only two studies included health professionals. Assuming self-management responsibility was viewed as part of normal development but was rarely explored within the context of the child gaining independence in other areas of their life. Children and parents adopted strategies to help the transfer, but there was limited evidence around health professionals' roles and ambivalence around what was helpful. There was a lack of clarity over whether children and parents were aiming for shared management, or self-management, and whether this was a realistic or desired goal for families. Multiple factors such as the child, family, social networks, health professional, and LTC influenced how a child assumed responsibility. CONCLUSIONS Evidence suggests that the parent-to-child transfer of self-management responsibility is a complex, individualized process. Further research across childhood LTCs is needed to explore children's, parents', and professionals' views on this process and what support families require as responsibilities change.

中文翻译：

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支持儿童和年轻人承担起父母对自己长期状况的自我管理的责任：综合审查。

背景技术具有长期病状（LTC）的儿童和年轻人通常依赖于其家庭或与他们的家庭共同管理，并期望随着他们的成熟而发展自我管理技能。但是，在青春期，年轻人会发现遵循规定的治疗方案具有挑战性，从而导致不良的临床结果。尽管评论着眼于子女和父母的自我管理经历，但没有人明确审查过父母对子女自我管理责任的转移。方法进行了综合审查，目的是通过解决两个问题来探讨LTC自我管理责任的父母之间的转移：（a）孩子如何从父母那里承担对LTC进行自我管理的责任？（b）哪些因素会影响父母对子女的责任转移？在八个数据库中搜索了1995年至2017年发表的论文。包括论文被合成以识别主题。结果确定了29篇论文。大多数论文都使用定性设计，并且主要针对糖尿病儿童。参加者主要是孩子和/或父母；只有两项研究包括卫生专业人员。假定自我管理责任被视为正常发展的一部分，但很少在儿童获得生活其他方面独立性的背景下进行自我探索。孩子和父母采取了帮助转移的策略，但是，关于卫生专业人员的作用以及对有益内容的模棱两可的证据有限。对于孩子和父母是否旨在共享管理或自我管理，以及对于家庭来说这是现实的还是期望的目标，目前还不清楚。儿童，家庭，社交网络，卫生专业人员和长期护理费用等多种因素影响着儿童承担责任的方式。结论证据表明，父母对子女自我管理责任的转移是一个复杂的，个性化的过程。需要对整个儿童期LTC进行进一步研究，以探索儿童，父母和专业人士对此过程的看法，以及随着责任的改变家庭需要哪些支持。对于孩子和父母是否旨在共享管理或自我管理，以及对于家庭来说这是现实的还是期望的目标，目前还不清楚。儿童，家庭，社交网络，卫生专业人员和长期护理费用等多种因素影响着儿童承担责任的方式。结论证据表明，父母对子女自我管理责任的转移是一个复杂的，个性化的过程。需要对整个儿童期LTC进行进一步研究，以探索儿童，父母和专业人士对此过程的看法，以及随着责任的改变家庭需要哪些支持。对于孩子和父母是否旨在共享管理或自我管理，以及对于家庭来说这是现实的还是期望的目标，目前还不清楚。儿童，家庭，社交网络，卫生专业人员和长期护理费用等多种因素影响着儿童承担责任的方式。结论证据表明，父母对子女自我管理责任的转移是一个复杂的，个性化的过程。需要对整个儿童期LTC进行进一步研究，以探索儿童，父母和专业人士对此过程的看法，以及随着责任的改变家庭需要哪些支持。医护人员和LTC影响了孩子承担责任的方式。结论证据表明，父母对子女自我管理责任的转移是一个复杂的，个性化的过程。需要对整个儿童期LTC进行进一步研究，以探索儿童，父母和专业人士对此过程的看法，以及随着责任的改变家庭需要哪些支持。医护人员和LTC影响了孩子承担责任的方式。结论证据表明，父母对子女自我管理责任的转移是一个复杂的，个性化的过程。需要对整个儿童期LTC进行进一步研究，以探索儿童，父母和专业人士对此过程的看法，以及随着责任的改变家庭需要哪些支持。