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[智利儿科学会青少年分会关于慢性病青少年从儿科向成人医疗服务过渡的建议]

[Transition from pediatric to adult health care services for adolescents with chronic diseases: Recommendations from the Adolescent Branch from Sociedad Chilena de Pediatría].

作者信息

Zubarew Tamara, Correa Loreto, Bedregal Paula, Besoain Carolina, Reinoso Alejandro, Velarde Macarena, Valenzuela María Teresa, Inostroza Carolina

机构信息

División de Pediatría, Facultad de Medicina, Pontificia Universidad Católica, Santiago, Chile.

Departamento de Salud Pública, Facultad de Medicina, Pontificia Universidad Católica, Santiago, Chile.

出版信息

Rev Chil Pediatr. 2017;88(4):553-560. doi: 10.4067/S0370-41062017000400018.

Abstract

The Adolescent Branch from Sociedad Chilena de Pediatría supports the implementation of planned programs for transition from child to adult health centers, oriented to adolescents with chronic diseases, in order to ensure an appropriate follow-up and a high-quality health care. Recommendations for care are set out in the FONIS and VRI PUC project carried out by the Division of Pediatrics of the Universidad Católica de Chile: “Transition process from pediatric to adult services: perspectives of adolescents with chronic diseases, caregivers and health professionals”, whose goal was to describe the experience, barriers, critical points, and facilitators in the transition process. Critical points detected in this study were: existence of a strong bond between adolescents, caregivers and the pediatric team, resistance to transition, difficulty developing autonomy and self-management among adolescents; invisibility of the process of adolescence; and lack of communication between pediatric and adult team during the transfer. According to these needs, barriers and critical points, and based on published international experiences, recommendations are made for implementation of gradual and planned transition processes, with emphasis on the design and implementation of transition policies, establishment of multidisciplinary teams and transition planning. We discuss aspects related to coordination of teams, transfer timing, self-care and autonomy, transition records, adolescent and family participation, need for emotional support, ethical aspects involved, importance of confidentiality, need for professional training, and the need for evaluation and further research on the subject.

摘要

智利儿科学会青少年分会支持实施针对慢性病青少年从儿童健康中心向成人健康中心过渡的计划项目,以确保进行适当的随访和高质量的医疗保健。智利天主教大学儿科学系开展的FONIS和VRI PUC项目阐述了护理建议:“从儿科服务向成人服务的过渡过程:慢性病青少年、照料者和卫生专业人员的观点”,其目标是描述过渡过程中的经历、障碍、关键点和促进因素。本研究发现的关键点包括:青少年、照料者与儿科团队之间存在紧密联系;对过渡存在抵触情绪;青少年难以培养自主性和自我管理能力;青春期过程不为人知;以及在转诊期间儿科团队与成人团队之间缺乏沟通。根据这些需求、障碍和关键点,并基于已发表的国际经验,提出了实施渐进式和计划性过渡过程的建议,重点是过渡政策的设计与实施、多学科团队的建立和过渡规划。我们讨论了与团队协调、转诊时机、自我护理与自主性、过渡记录、青少年及家庭参与、情感支持需求、涉及的伦理问题、保密的重要性、专业培训需求以及对该主题进行评估和进一步研究的需求等相关方面。

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