Home Health Care Providers’ Readiness to Care for Children and Youth With Complex Medical Conditions: Protocol for a Scoping Review (Preprint)
Notice bibliographique
Résumé
BACKGROUND Children and youth with medical complexities have chronic conditions, functional limitations, and extensive care needs requiring significant family involvement and frequent health service use. Pediatric medicine has improved their life expectancy, shifting care from acute to home settings. In Ontario, home care is publicly funded and includes nursing, therapy, personal support, and allied health services. However, families continue providing the bulk of care, often at great personal costs. As care complexity increases, so does the reliance on home care providers. Yet, many providers report feeling unprepared due to insufficient pediatric training, lack of supervision, and system-level gaps. Here we applied Weiner’s theory of organizational readiness for change, framing readiness as a shared psychological state involving commitment to and confidence in delivering change, thus helping conceptualize provider readiness as encompassing individual competence, contextual supports, and motivational factors. Despite its importance, provider readiness in pediatric home care remains poorly understood. OBJECTIVE We examine how home care providers perceive their readiness to care for children and youth with medical complexities, factors influencing readiness, and strategies proposed to enhance their capacity to deliver safe, coordinated, developmentally appropriate home care. METHODS This scoping review follows the updated Joanna Briggs Institute scoping review methodology and PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) guidelines. Articles focusing on (1) children and youth with medical complexities aged 0-18 years receiving home care and (2) with at least one chronic medical condition, and (3) paid home care providers will be searched on MEDLINE, CINAHL, Scopus, ProQuest Nursing & Allied Health, PsycINFO, Cochrane Central Register of Controlled Trials, and Cochrane Database of Systematic Reviews. Gray literature will be searched on Google Scholar and ProQuest (Dissertations & Theses). A 2-stage screening process will be conducted in Covidence, involving title and abstract screening and full-text review by 2 independent reviewers. Data will be extracted using predefined charting categories and analyzed using both qualitative and quantitative approaches. RESULTS As of May 2025, screening is underway. The review will map key themes across provider types, care settings, and training contexts and identify factors influencing provider readiness including access to training, system navigation supports, and workplace role clarity and chart recommendations or strategies to enhance readiness. Gaps in pediatric-specific competencies and workforce preparation may also emerge. CONCLUSIONS This review will synthesize current evidence on provider readiness in pediatric home care, identifying strengths, challenges, and development areas. Findings will inform provider training, workforce development, and policy strategies to ensure children and youth with medical complexities receive safe, coordinated, effective home care. A deeper understanding of provider readiness will support more sustainable home care systems and improve outcomes for children and youth with medical complexities and their families. CLINICALTRIAL OSF Registries 10.17605/OSF.IO/N4FAJ; https://osf.io/n4faj INTERNATIONAL REGISTERED REPORT PRR1-10.2196/76796
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,080 | 0,106 |
| Méta-épidémiologie (sens strict) | 0,005 | 0,006 |
| Méta-épidémiologie (sens large) | 0,013 | 0,016 |
| Bibliométrie | 0,015 | 0,015 |
| Études des sciences et des technologies | 0,005 | 0,004 |
| Communication savante | 0,009 | 0,008 |
| Science ouverte | 0,005 | 0,006 |
| Intégrité de la recherche | 0,007 | 0,008 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,117 | 0,016 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».