Department of Medical Education, University of Melbourne, Melbourne, Australia.
Melbourne Graduate School of Education, University of Melbourne, Melbourne, Australia.
World J Pediatr Congenit Heart Surg. 2023 May;14(3):357-363. doi: 10.1177/21501351221149897. Epub 2023 Feb 23.
Almost 90% of infants with congenital heart disease (CHD) now reach adulthood but require long-term surveillance to recognize and manage residual and/or evolving lesions. Yet many are lost to follow-up. A scoping review identified four specific domains that pose barriers to consistent follow-up. There are multiple issues associated with transition from pediatric to adult care which included-the lack of a seamless transfer, the establishment of a new trusting relationship, promoting the right balance of patient autonomy and addressing knowledge gaps. Additional issues related to logistic problems of time, distance, cost, and the availability of specialized care, are further compounded by the psychosocial factors and the heterogeneity of the cardiac abnormality affecting our patients. Further study of all these issues is warranted to improve ongoing engagement.
目前，近 90%的先天性心脏病（CHD）患儿能够成年，但需要长期监测以识别和管理残留的和/或进展性病变。然而，许多患者都失去了随访。一项范围界定综述确定了四个具体领域，这些领域对持续随访构成了障碍。从儿科到成人护理的过渡存在多个问题，包括-缺乏无缝过渡、建立新的信任关系、促进患者自主权的适当平衡以及解决知识差距。与时间、距离、成本和专科医疗的可及性相关的其他问题，以及心理社会因素和影响我们患者的心脏异常的异质性，进一步加剧了这些问题。需要进一步研究所有这些问题，以改善持续参与。
