Transition for Adolescents and Young Adults With Asthma

Abstract

Asthma is a complex, heterogenous medical condition which is very common in children and adults. The transition process from pediatric to adult health care services can be a challenge for young people with chronic medical conditions. The significant changes in physical and mental health during this time, as well as the many unique developmental and psychosocial challenges that occur during adolescence can complicate and impede transition if not adequately addressed and managed. The transition period can also be a challenging time for health professionals to assess readiness for transition and manage some of the complications which are particularly common during this time, including poor adherence to therapy, smoking, drug use, and emerging mental health conditions. The natural history, presentation, symptoms, and management of asthma is often significantly different when comparing pediatric and adult practice. In addition, management in infants, toddlers, school aged children, and adolescents differs significantly, offering an additional challenge to pediatric physicians managing asthmatic children and young people. Despite these challenges, if the transition process for young people with asthma is planned and performed in a formalized manner, many of these issues can be addressed, allowing the transition to occur smoothly despite changes that may occur in medical and psychosocial domains.

Understanding the health-care experiences of people with sickle cell disorder transitioning from paediatric to adult services: This Sickle Cell Life, a longitudinal qualitative study

“…15 However, young people's voices are not usually included in health-care transition research to the extent needed 54 and their experiences of transitions in care outside specialist services across the health-care system remains largely unexamined. Top-down approaches to health-care service planning 55 that do not involve patients dominate current provision. 56 Self-management of SCD is demanding and requires close self-monitoring [e.g.…”

<p>Pre-Transition Readiness in Adolescents and Young Adults with Four Chronic Medical Conditions in South East Nigeria – An African Perspective to Adolescent Transition</p>

“…16 Studies have reported the importance of having good communication skills and having good knowledge of medication intake before being considered as ready to be moved over to adult care. 16,17 We noted that excellent communication skills alongside good knowledge of ones chronic illness did not translate to acceptability of change from paediatric care to adult-oriented care, because although females had better communication skills and were more open to ask questions, the knowledge acquired from the interaction did not positively affect their readiness to move over to adult care. This emphasizes the need to start on time to impart communication and interaction skills to children as this will be of great benefit to them even during the pre-transition stage.…”

“…Based on their respective population in the clinics, we recruited consecutively the proportionate sample size required from the various clinics: 63, 39, 36 and 23 from, HIV, sickle cell anaemia, asthma, nephrology clinics, respectively. To collect data on transition readiness, the validated intervieweradministered Self-management and Transition to Adulthood with Treatment (STARx) questionnaire [15][16][17] was pretested and found to have good internal consistency (Cronbach's alpha 0.8), and was used via intervieweradministered survey. The STARx questionnaire also has external validity meaning that it can be applied to make deductions outside the context of children with asthma, sickle cell, nephrotic syndrome and HIV disease as it has been applied across a wide range of several other chronic conditions and found to be a sound tool that informed decisions for those chronic conditions.…”

“…The STARx questionnaire also has external validity meaning that it can be applied to make deductions outside the context of children with asthma, sickle cell, nephrotic syndrome and HIV disease as it has been applied across a wide range of several other chronic conditions and found to be a sound tool that informed decisions for those chronic conditions. [15][16][17][18][19][20] The STARx questionnaire has a total of 18 questions with three subdomains. The subdomains contain nine questions on Self-Management methods which includes questions like: How easy or hard is it to take your medicines like you are supposed to?…”

Perceptions of childhood asthma and its control among Malays in Malaysia: a qualitative study

“…A previous study found the negative experience with healthcare provider influenced health-seeking behaviour 46 . Children should be reviewed for asthma even if the asthma is mild, as it could recur in adulthood, and childhood asthma is a risk factor for later developing pulmonary disease 47 . The National Asthma and Education Program suggested that parents should inform the teacher about their children's written asthma action plan to guide the teacher during emergencies rather than waiting for parents to fetch their children at school without taking immediate action that could save a life.…”