Adolescent developmental needs: lost or addressed in health sector transitions?

PURPOSE: To produce a conceptual summary of literature focusing on models which inform and guide the transition from paediatric to adult services for Adolescents and Young Adults (AYA). The review was conducted as part of a larger study exploring the experiences of AYA in their transition from the paediatric to the adult cancer setting. THEORY: This review draws on interpersonal, relational and social constructionist perspectives of adolescence and Erikson's stages of psycho-social development. METHODS: A critical narrative review, informed by systematic techniques for searching and appraisal, was conducted on recently published (1998–2008) literature which focused on transition models from across a range of illness conditions. RESULTS AND CONCLUSIONS: Current models do not adequately meet the needs of adolescents during transition as they are limited by the level of understanding of adolescent development which they incorporate. Therefore, models are needed which reflect the dynamic and often complex nature of adolescence and contextualise the interrelationship of transitioning between services and life-course transitions for AYA with chronic conditions. DISCUSSION: To ensure effective co-ordination and continuity of care during the transition process, pathways of care should be informed by and constructed within both medical and psycho-social paradigms.