Ramirez Lauren Natalia, Hoyos María Elisa, Mosquera-Pongutá Angela Catalina, Quintana-López Gerardo
Grupo de Investigación Reumavance, Facultad de Medicina, Universidad Nacional de Colombia, Bogotá, Colombia.
Grupo de Investigación Reumavance, Facultad de Medicina, Universidad de los Andes, Bogotá, Colombia.
Adv Rheumatol. 2025 Jan 2;65(1):1. doi: 10.1186/s42358-024-00419-2.
Transition clinics are conceived as programs dedicated to the active, multidimensional development of a process that addresses the medical, psychosocial, educational, and vocational needs of pediatric patients suffering from a chronic disease that will persist into adulthood. Their understanding is justified in physiological, psychological, and sociocultural terms on the basis of the differential morbidity and mortality associated with a chronic disease that begins in childhood and prevails into adulthood.
Here, we reflect on the history, structure, and impact of transition clinics in pediatrics, with an emphasis on pediatric rheumatologic diseases. Additionally, we propose comprehensive reflection as an alternative for the patient, their family, and the medical team, outlining guidelines for development, implementation, and evaluation.
The transition of care should commence in early adolescence, considering each patient's cognitive ability as a condition for the initiation of an educational process involving introspection into the disease. Interdisciplinarity is defined as a team that addresses the clinical, physical, emotional, and social dimensions of each patient and their interaction with the environment within the framework of individualized care and family support. Despite this, the lack of evidence supporting standardized guidelines for the implementation and overall effectiveness evaluation of these interventions was highlighted.
The transition process is considered successful when the patient is adherent and has a positive and informed perception of their health‒disease journey. We urge the generation of evidence documenting the comprehensiveness of processes inherent to transition clinics as the foundation of necessity.
过渡诊所被视为致力于积极、多维度开展一个过程的项目,该过程旨在满足患有慢性疾病且病情会持续至成年期的儿科患者在医疗、心理社会、教育和职业方面的需求。基于与始于儿童期并延续至成年期的慢性疾病相关的发病率和死亡率差异,从生理、心理和社会文化角度来看,对过渡诊所的理解是合理的。
在此,我们思考儿科过渡诊所的历史、结构和影响,重点关注儿科风湿性疾病。此外,我们提出全面反思作为患者、其家庭和医疗团队的一种选择,并概述其发展、实施和评估指南。
护理过渡应在青春期早期开始,将每位患者的认知能力作为启动涉及对疾病进行内省的教育过程的条件。跨学科性被定义为一个团队,在个性化护理和家庭支持的框架内,处理每位患者的临床、身体、情感和社会层面以及他们与环境的相互作用。尽管如此,仍强调缺乏支持这些干预措施实施和总体效果评估的标准化指南的证据。
当患者坚持并对其健康 - 疾病历程有积极且明智的认知时,过渡过程被认为是成功的。我们敦促生成证据,记录过渡诊所固有过程的全面性,作为必要性的基础。