The Child Growth Foundation, Sutton Coldfield, UK
University Hospital of Wales, Noah’s Ark Children’s Hospital for Wales, Children’s Hospital, Cardiff, UK
J Clin Res Pediatr Endocrinol. 2020 Sep 2;12(3):225-232. doi: 10.4274/jcrpe.galenos.2019.2019.0153. Epub 2019 Nov 20.
Long-term growth management can be challenging for patients, families and healthcare professionals (HCP). Personalised optimal responses to growth hormone (GH) therapy depend on the creation of a good working relationship between the patient and family and the HCPs responsible for care. Current unmet needs in growth management will be discussed, focusing on the likelihood of a poor growth response and its identification and management with emphasis on the importance of good adherence to GH therapy. Digital tools are now available to record injections and communicate accurate adherence data to the HCP and patient. Psychological barriers to good adherence will be covered, with techniques identified to change behaviour and improve outcome. Motivational interviewing is a valuable skill in this respect and should be taught to both medical and nursing HCPs to enhance the quality of the relationship with the patient and family. Key messages are, firstly, the importance of personalised care with the HCP using acquired psychological skills to prevent and manage poor adherence. Secondly, a human-eHealth partnership is necessary to maximise the benefit of new digital tools to aid in successful growth management.
长期生长管理对患者、家庭和医疗保健专业人员(HCP)来说可能具有挑战性。个人对生长激素(GH)治疗的最佳反应取决于患者及其家庭与负责治疗的 HCP 之间建立良好的工作关系。目前将讨论生长管理方面的未满足需求,重点关注不良生长反应的可能性及其识别和管理,强调遵守 GH 治疗的重要性。现在有数字工具可用于记录注射并将准确的依从性数据传达给 HCP 和患者。将涵盖良好依从性的心理障碍,并确定改变行为和改善结果的技术。在这方面,动机性访谈是一项有价值的技能,应教授给医疗和护理 HCP,以增强与患者及其家庭的关系质量。主要信息是,首先,HCP 使用获得的心理技能进行个性化护理以预防和管理不良依从性非常重要。其次,需要建立一个人类电子健康合作伙伴关系,以最大限度地利用新的数字工具的优势,帮助成功进行生长管理。