Cooper Felicia, Pierce Jessica, Vyas Neha
Division of Endocrinology, Nemours Children's Health, 6535 Nemours Parkway, Orlando, FL 32827, USA.
Health Care Transit. 2024 Jun 18;2:100060. doi: 10.1016/j.hctj.2024.100060. eCollection 2024.
Adolescence is a challenging time in a child's life and can be even more stressful for those with a chronic medical condition such as diabetes mellitus. Adolescents and young adults with type 1 and type 2 diabetes experience worsening glycemic levels as they enter adulthood. Data suggest that a formalized health care transition process and beginning transition preparation in early adolescence leads to better transition outcomes.
The aim of this study was to create a transition of care program for youth with diabetes in a standalone children's hospital by following the Got Transition Six Core Elements of Health Care Transition. First, we implemented a transition of care policy and formalized how we discussed transition of care with patients and families in early adolescence. Further improvements have included assessing readiness to transition, designing a curriculum centered around adolescent-specific issues and how they relate to diabetes management, and forming connections with adult endocrinologists in the area to establish a seamless transition process.
After implementing our program, 90 % (28/31) of our patients indicated they were very or somewhat ready to transition to adult care.
We outline our process for developing a transition of care program and provide a practical tool for other pediatric diabetes providers who are interested in implementing a similar program.
青春期是儿童生命中充满挑战的时期,对于患有糖尿病等慢性疾病的儿童来说,压力可能更大。1型和2型糖尿病的青少年及年轻成年人在步入成年期时血糖水平会恶化。数据表明,一个正式的医疗保健过渡过程以及在青春期早期开始过渡准备会带来更好的过渡结果。
本研究的目的是通过遵循“实现过渡”医疗保健过渡的六个核心要素,为一家独立儿童医院中患有糖尿病的青少年创建一个护理过渡项目。首先,我们实施了一项护理过渡政策,并规范了在青春期早期我们与患者及其家庭讨论护理过渡的方式。进一步的改进包括评估过渡准备情况、设计一门围绕青少年特定问题及其与糖尿病管理的关系的课程,以及与该地区的成人内分泌科医生建立联系以建立无缝过渡过程。
实施我们的项目后,90%(28/31)的患者表示他们非常或有点准备好过渡到成人护理。
我们概述了我们制定护理过渡项目的过程,并为其他有兴趣实施类似项目的儿科糖尿病提供者提供了一个实用工具。