Center for Translational Science, Children's National Medical Center, 111 Michigan Ave NW, Washington, DC, 20010, USA,
Curr Diab Rep. 2013 Dec;13(6):900-8. doi: 10.1007/s11892-013-0420-x.
Transition from pediatric to adult care represents a high risk period for adolescents and emerging adults with diabetes. Fundamental differences between pediatric and adult care delivery models may contribute to increased risk for poor health outcomes. This review provides a brief overview of models of care in pediatric and adult settings and focuses on patient-provider communication content and quality as potential points of intervention to improve transition-related outcomes. This review also highlights disparities in transition and communication for adolescents and emerging adults from racial/ethnic minority groups and discusses recent changes in health care legislation that have significant implications for the transition process. Intervention opportunities include programs to enhance developmentally-appropriate patient-provider interactions and increased attention to promoting transition readiness skills. Improving patient-provider communication may hasten the development of vital self-advocacy skills needed in adult health care systems and, thus, help establish a lasting pattern of positive diabetes self-care.
从儿科到成人护理的过渡时期对于患有糖尿病的青少年和刚成年的患者来说是一个高风险时期。儿科和成人护理模式之间的根本差异可能会增加不良健康结果的风险。这篇综述简要介绍了儿科和成人环境中的护理模式,并重点介绍了患者与提供者之间沟通的内容和质量,这可能是改善与过渡相关的结果的干预点。这篇综述还强调了少数族裔青少年和刚成年患者在过渡和沟通方面的差异,并讨论了医疗保健立法的最新变化,这些变化对过渡过程具有重大影响。干预机会包括旨在增强与患者和提供者之间的发展相关的互动以及更多关注促进过渡准备技能的项目。改善患者与提供者之间的沟通可以加速发展在成人保健系统中所需的重要的自我倡导技能,从而有助于建立积极的糖尿病自我护理的持久模式。