Buhlmann U, Fitzpatrick S B
Prim Care. 1987 Mar;14(1):57-68.
Although early, mid, and late adolescence are transient psychological periods, the teenager must master these three phases to complete the psychological stages and tasks of adolescence. Because chronic disease delays or alters these phases, it becomes imperative for the primary care physician to reassess psychological development periodically for appropriate and intensive counseling. With the advantage of continuous contact with the family and the understanding of the family's structure and interpersonal relationships, the primary care physician may be able to: alleviate struggles for control that may seriously impede care, encourage the teenager to accomplish the psychological tasks of adolescence, both during hospitalization and in follow-up outpatient care visits, promote the adolescent's participation in his or her own health care, and ultimately enhance both the family's and the teenager's adaptation to a chronic illness. Finally, during the terminal phase of an illness, the primary care physician will be able to help the adolescent find meaning in his or her short life, provide the support to help the teenager to disengage from life with dignity, and provide a supportive relationship to the parents and siblings.
尽管青春期早期、中期和晚期是短暂的心理阶段，但青少年必须掌握这三个阶段，以完成青春期的心理阶段和任务。由于慢性病会延迟或改变这些阶段，因此初级保健医生必须定期重新评估心理发展情况，以便进行适当和深入的咨询。凭借与家庭持续接触的优势以及对家庭结构和人际关系的了解，初级保健医生或许能够：缓解可能严重妨碍治疗的控制权争夺，鼓励青少年在住院期间和后续门诊就诊时完成青春期的心理任务，促进青少年参与自身的医疗保健，最终增强家庭和青少年对慢性病的适应能力。最后，在疾病的终末期，初级保健医生将能够帮助青少年在其短暂的生命中找到意义，提供支持以帮助青少年有尊严地离世，并为父母和兄弟姐妹提供支持性的关系。
