Guy's and St Thomas' NHS Foundation Trust, Thoracic Medicine, Guy's Severe Asthma Service, London, England.
Paediatrics Department, North Middlesex University Hospital Trust, London, England.
Chest. 2021 Oct;160(4):1192-1199. doi: 10.1016/j.chest.2021.05.019. Epub 2021 May 19.
Children with asthma grow to become adults with asthma. Adolescents are not simply older children and do not automatically transform into independent adults, nor do they become proficient in self-management of their condition overnight. Adolescence is a high-risk time for many people with asthma, with increased risk of asthma-related morbidity and mortality. Children with high-risk asthma attend hospital-based asthma clinics with their parents until they reach young adulthood, and parents usually take on the significant burden of disease management on behalf of their children. Once patients are transferred to adult medical teams, many will continue to have limited knowledge about their asthma, limited understanding of how to manage their symptoms and comorbidities, and limited comprehension of how and why to take their regular medication. Adolescence is a critical time of change during which young people yearn for autonomy. Effective transition gives young people the skills and knowledge necessary to manage their health independently and provides the substrate for autonomous care, the bed rock of long-term conditions. This review focuses on the challenges of adolescent health care and provides guidance on how to take a planned, patient-centered approach to ensure each transition is effective and safe.
儿童哮喘会发展为成人哮喘。青少年并非简单的大龄儿童，他们不会自动转变为独立的成年人，也不会在一夜之间精通自身疾病的自我管理。对于许多哮喘患者来说，青春期是一个高风险时期，哮喘相关发病率和死亡率的风险增加。有高风险哮喘的儿童在成年之前会与父母一起到医院的哮喘诊所就诊，并且父母通常会代表孩子承担疾病管理的重要负担。一旦患者转入成人医疗团队，许多人对哮喘的了解仍将有限，对如何管理症状和合并症的理解有限，对如何以及为何服用常规药物的理解也有限。青春期是一个发生重大变化的关键时期，在此期间年轻人渴望自主。有效的过渡为年轻人提供了独立管理健康所需的技能和知识，并为自主护理提供了基础，而自主护理是长期疾病的基石。本篇综述聚焦于青少年医疗保健的挑战，并提供了如何采取计划、以患者为中心的方法的指导，以确保每次过渡都是有效且安全的。
