Abraham A, Silber T J, Lyon M
Department of General Pediatric and Adolescent Medicine, Children's National Medical Center, Washington DC, USA.
Indian J Pediatr. 1999 May-Jun;66(3):447-53. doi: 10.1007/BF02845539.
Success in the survival of children with significant medical conditions has resulted in a dramatic increase in the prevalence of adolescents with chronic illness. Unfortunately, the traditional biomedical approach does not prepare practitioners for the complexities of managing chronic illness, because numerous psychosocial factors are involved. This article will address the need for integrating psychosocial issues into the assessment and treatment of the chronically ill adolescent. Assessment of the teen should incorporate an understanding of the developmental stages of adolescence, a review of how these developmental tasks are being accomplished, a discernment of individual characteristics, and knowledge of the family and community to which they belong. Management should take into account the phases of illness (acute, chronic or terminal) and encourage empowerment of the adolescent and family in decision making. A team approach that is community-based, comprehensive, and culturally appropriate is ideal.
患有严重疾病的儿童存活率的提高,导致慢性病青少年的患病率急剧上升。不幸的是,传统的生物医学方法无法让从业者应对慢性病管理的复杂性,因为其中涉及众多心理社会因素。本文将探讨将心理社会问题纳入慢性病青少年评估和治疗的必要性。对青少年的评估应包括对青春期发育阶段的理解、对这些发育任务完成情况的回顾、对个体特征的识别以及对他们所属家庭和社区的了解。管理应考虑疾病阶段(急性、慢性或终末期),并鼓励青少年及其家庭在决策中增强自主权。基于社区、全面且符合文化背景的团队方法是理想的。