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To summarize current evidence regarding preferences for self-management behaviours among adolescents and young adults (AYAs) with chronic diseases during the healthcare transition period.
Mixed-methods systematic review.
The review following the Joanna Briggs Institute Mixed Methods Systematic Review (JBI M-MSR) methodology convergent integrated approach, which is separate qualitative and quantitative syntheses followed by integration in a narrative form. The methodological quality of included articles was assessed using the Mixed Methods Appraisal Tool.
We searched nine databases (PubMed, Web of Science, Scopus, MEDLINE, CINAHL Plus, psyINFO, CNKI, Wan Fang and SinoMed) from their inception up to December 4, 2025, restricting results to English and Chinese publications.
A total of 31 studies were included in the review. These studies synthesise three main themes: (1) preferences for medical management behaviours; (2) preferences for emotional coping strategies and (3) preferences for role and identity maintenance.
This review underscores the importance of understanding AYAs' preferences for self-management behaviours during healthcare transition, offering insights to improve their engagement and adherence.
Healthcare providers can improve transition outcomes for AYAs with chronic diseases by surveying their preferences for self-management behaviours and creating tailored plans.
Highlights the importance of considering diverse preferences for self-management behaviours. Contributes to improving health outcomes and quality of life for AYAs during healthcare transitions.
The Preferred Reporting Items for Systematic Reviews and Meta Analysis (PRISMA) checklist was followed.
This study did not include patient or public involvement in its design, conduct, or reporting.
To explore the possible barriers and facilitators to implementing the Upright Positions in the Second Stage of Labour (UPSSL) programme in Chinese healthcare settings.
A mixed-method convergent design with the guidance of Consolidated Framework for Implementation Research (CFIR).
An online survey study and semi-structured interviews were conducted between March and May 2023. Healthcare professionals were recruited from four hospitals in Shijiazhuang, China. One hundred and thirty-one participants completed the survey study, and 23 of them were interviewed individually. Descriptive statistics evaluated the possible barriers and facilitators of implementing the UPSSL programme within the CFIR framework quantitatively. Guided by the CFIR framework, qualitative data were analysed using directed content analysis to summarize healthcare professionals' perspectives on barriers and facilitators of the UPSSL programme.
Multiple intersectional barriers and facilitators were identified from the survey and semi-interviews. Healthcare professionals believed that the UPSSL programme has a scientific evidence base, systematic contents, and possible benefits for women. However, various barriers existed at individual, system, and organizational levels. Major barriers included healthcare professionals and women's safety concerns towards the use of upright positions during childbirth, the healthcare professionals' unfamiliarity with assisting an upright position birth, poor adaptability of the programme protocol, inadequate facilities and staffing, and a lack of readiness to change in the clinical setting.
To facilitate the implementation of the UPSSL programme in China, tailored antenatal education on upright positions, especially addressing safety-related issues, should be provided to pregnant women, their families, or peers to enhance their understanding of and familiarity with such positions. Healthcare professionals should also be offered adequate training opportunities and necessary facilities. Furthermore, national-level policy changes might be required to address midwifery workforce shortages. Additionally, further research is warranted to select, adapt, and test effective implementation strategies for programme adoption.
What problem did the study address? The adoption of upright positions during the second stage of labour could promote better maternal and neonatal outcomes and a positive childbirth experience. However, the adoption of upright positions during the second stage of labour is suboptimal in healthcare settings in China. Barriers and facilitators of implementing upright positions during childbirth are unclear. What were the main findings? A range of barriers and facilitators within the CFIR framework to promote upright positions during childbirth from healthcare professionals' perspectives were identified, and the major barriers included safety concerns towards and unfamiliarity with an upright position birth, inadequate facilities and staffing, and a lack of readiness to change in the clinical setting. Where and on whom will the research have an impact? This study will enable a better understanding of the barriers and facilitators to promoting upright positions in the second stage of labour in China. The smooth and effective implementation of the UPSSL programme could help to promote better maternal and neonatal outcomes and improve women's childbirth experiences.
The reporting of this study followed the Consolidated Criteria for Reporting Qualitative Research (COREQ) and Good Reporting of A Mixed Methods Study (GRAMMS) guidelines.
In this study, healthcare professionals were involved in refining the topic guides and survey questions. Additionally, findings from the interviews were returned to them for comments and corrections.
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