Facilitating the Transition of Adolescents With Chronic Conditions From Pediatric to Adult Health Care and Community Settings

Abstract

This article provides an overview of the health care issues and concerns of adolescents with special health care needs and disabilities who are in transition from pediatric to adult health care settings. Adolescents and their families face numerous challenges in accessing adult health care providers who can give adequate primary and specialized health care services to this growing population of youth. Navigating the myriad new and unfamiliar adult services available can be overwhelming for adolescents, their families, and pediatric providers. Assessment and intervention strategies are described that can be used by the pediatric nurse to facilitate successful transitions to adult health care and community-based services.

Concept Analysis of Health Care Transition in Adolescents with Chronic Conditions

“…These revolve around the achievement of autonomy and independence in health-related decision-making and self-care. Variations of the same theme include self-sufficiency, self-management, mastery, competence, and shared-care (AAP, 2013;Betz, 1998aBetz, , 1998bBetz, 2000;Fleming et al, 2002;Hergenroeder, 2002;Higgins & Tong, 2003;Kelly et al, 2002;Luther, 2001;Okumura et al, 2014;Swallow et al, 2013;Tong & Kools, 2004;Towns & Bell, 2010)). Other noted consequences include normalization, reassignment of roles and responsibilities, and reintegration into a new system of adult health (Kelly et al, 2002).…”

“…There is a critical need to prepare nurses at all levels, especially those at the advanced practice/nurse practitioner roles, to provide compassionate, developmentally-appropriate care to adolescents with chronic conditions (Betz, 1998b;Betz & Redcay, 2005;Hauser & Dorn, 1999;Higgins & Tong, 2003). A sensitive discussion on transitioning to AHC must be initiated in a timely manner while their health status is stable.…”

“…A sensitive discussion on transitioning to AHC must be initiated in a timely manner while their health status is stable. Nurse practitioners specializing in adult health must take a side course or continuing education unit on caring for young people with "childhood" diseases (Betz, 1998b;Betz & Redcay, 2005;Hauser & Dorn, 1999). Their knowledge and skills must be able to meet the unique needs of these young patients.…”

Experiences of adolescents with Cystic Fibrosis during their transition from paediatric to adult health care: a qualitative study of young Australian adults

“…Other literature indicates that an obstacle to a successful transition may occur if the paediatric caregiver has strong emotional bonds with the family and the patient, or does not trust the adult caregiver. 23,24 In addition, Rosen 7 has indicated that the paediatric doctor's perceptions are unintentionally communicated to patients and families and that this may compound their resistance to transition efforts.…”

Development and Implementation of an Adolescent Epilepsy Transition Clinic

“…F or more than a decade, child health advocates have recognized that adolescents with chronic health conditions require a well-planned and coordinated transition between pediatric and adult services (Alberta Child and Youth Initiative, 2007;American Academy of Pediatrics, 2002;Betz, 1998Betz, , 2004Blum, 1995;Blum et al, 1993;Canadian Paediatric Society, 2007;McDonagh, 2007). However, most of the information regarding transition is in the form of policy recommendations or is anecdotal, with scant literature describing detailed transition services for adolescents with special healthcare needs (Betz & Redcay, 2003).…”