Kim Jeongseok, Ye Byong Duk
Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
Department of Inflammatory Bowel Disease Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
Intest Res. 2019 Jan;17(1):24-35. doi: 10.5217/ir.2018.00128. Epub 2018 Nov 12.
The incidence of pediatric-onset inflammatory bowel disease (IBD) is on the rise, accounting for up to 25% of IBD cases. Pediatric IBD often has extensive bowel involvement with aggressive and rapidly progressing behavior compared to adult IBD. Because IBD has a high morbidity rate and can have a lifelong impact, successful transition from pediatric to adult care is important to maintain the continuity of care. Furthermore, successful transition facilitates appropriate development and psychosocial well-being among patients, as well as comprehensive and harmonious healthcare delivery amongst stakeholders. However, there are various obstacles related to patients, family, providers, and organizations that interfere with successful transition. Successful transition requires a flexible and tailored plan that is made according to the patient's developmental abilities and situation. This plan should be established through periodic interviews with the patient and family and through close collaboration with other care providers. Through a stepwise approach to the transition process, patients' knowledge and self-management skills can be improved. After preparation for the transition is completed and the obstacles are overcome, patients can be gradually moved to adult care. Finally, successful transition can increase patients' adherence to therapy, maintain the appropriate health status, improve patients' self-management, and promote self-reliance among patients.
儿童期起病的炎症性肠病（IBD）发病率正在上升，占IBD病例的25%。与成人IBD相比，儿童IBD通常肠道受累广泛，病情侵袭性强且进展迅速。由于IBD发病率高且可能产生终身影响，从儿科护理成功过渡到成人护理对于维持护理的连续性很重要。此外，成功过渡有助于患者实现适当的成长和心理社会幸福感，以及各利益相关方提供全面、协调的医疗服务。然而，患者、家庭、医疗服务提供者和组织等方面存在各种阻碍成功过渡的因素。成功过渡需要根据患者的发育能力和情况制定灵活且量身定制的计划。该计划应通过定期与患者及家庭面谈，并与其他护理提供者密切合作来制定。通过逐步推进过渡过程，可以提高患者的知识水平和自我管理技能。在完成过渡准备并克服障碍后，患者可逐渐转至成人护理。最后，成功过渡可提高患者对治疗的依从性，维持适当的健康状况，改善患者的自我管理能力，并促进患者的自立能力。
