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Fonseca H, Michaud PA. The state of adolescent medicine as a specific field: an international exploratory survey. Int J Adolesc Med Health 2023; 35:173-177. [PMID: 34162034 DOI: 10.1515/ijamh-2021-0049] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Accepted: 05/16/2021] [Indexed: 04/30/2023]
Abstract
OBJECTIVES The emergence of adolescent medicine (AM) as a specific area of training and health care delivery is progressing at various pace around the world. The objective of this exploratory survey was to inquire about the existence of official bodies and institutions offering recognition of the discipline as a specific field and on the status of related training initiatives. METHODS A questionnaire was spread among a convenience sample of 21 colleagues involved in adolescent health care around the world, and answers were collected and analysed manually. RESULTS All 21 colleagues from the North and South American, African, Asian and European regions have responded. Only seven countries report the existence of adolescent inpatient wards in some hospitals, while 16 have specialized outpatient clinics; in only eight countries is formal mandatory training in AM required for paediatricians; in seven others, such a stay is available but optional. Six countries have implemented a systematic assessment tackling AM in the certification process of paediatricians and just four recognize AM as a sub-specialty. Only two countries mention compulsory training in AM for family doctors. Fourteen countries report on the existence of an AM association. CONCLUSIONS Despite an encouraging number of initiatives testifying the growing place of AM in the practice of medicine, our data bring a worrisome portray of the status of AM in the involved countries and call for the development of appropriate health care and training centres.
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Affiliation(s)
- Helena Fonseca
- Adolescent Medicine Division, Department of Pediatrics, Hospital de Santa Maria, Faculty of Medicine, Lisboa, Portugal
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2
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Tellier PP, Ataman R, Zaccagnini M, Gore G, Rodriguez C. Adolescent medicine training in postgraduate family medicine education: a scoping review. Int J Adolesc Med Health 2023; 35:119-129. [PMID: 36584348 DOI: 10.1515/ijamh-2022-0087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Accepted: 12/07/2022] [Indexed: 01/01/2023]
Abstract
INTRODUCTION Adolescents and young adults require age-appropriate healthcare services delivered by clinicians with expertise in adolescent medicine. However, resident family physicians report a low perceived self-efficacy and under-preparedness to deliver adolescent medical care. We conducted a scoping review to map the breadth and depth of the current evidence about adolescent medicine training for family medicine residents. CONTENT We followed Arksey and O'Malley's framework and searched seven electronic databases and key organizations' webpages from inception to September 2020. Informed by the CanMEDS-FM, we analyzed the extracted data concerning basic document characteristics, competencies and medical topics using numerical and qualitative content analysis. SUMMARY We included 41 peer-reviewed articles and six adolescent health competency frameworks (n=47). Most competencies taught in family medicine programs were organized under the roles of family medicine expert (75%), communicator (11.8%), and professional roles (7.9%). Health advocate and leader were rarely included (1.3%), and never scholar. OUTLOOK The omission of multiple competency roles in family medicine resident education on adolescents is insufficient for family physicians to deliver optimal care to adolescents. The combined efforts of family medicine stakeholders to address adolescent medicine competency gaps may positively impact the perceived competence reported by family medicine residents.
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Affiliation(s)
| | - Rebecca Ataman
- The School of Physical and Occupational Therapy, McGill University, Montréal, QC, Canada.,The Centre for Interdisciplinary Research in Rehabilitation of Greater Montréal, Laval, QC, Canada
| | - Marco Zaccagnini
- The School of Physical and Occupational Therapy, McGill University, Montréal, QC, Canada.,The Centre for Interdisciplinary Research in Rehabilitation of Greater Montréal, Laval, QC, Canada
| | - Geneviève Gore
- McGill Schulich Library of Physical Sciences, Life Sciences and Engineering, McGill University, Montréal, QC, Canada
| | - Charo Rodriguez
- Department of Family Medicine, McGill University, Montréal, QC, Canada.,The Institute of Health Sciences Education, McGill University, Montréal, QC, Canada
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3
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Michaud PA, Visser A, Vervoort J, Kocken P, Reijneveld S, Blair M, Alexander D, Rigby M, Weber M, Jansen D. Do European Union countries adequately address the healthcare needs of adolescents in the area of sexual reproductive health and rights? Arch Dis Child 2020; 105:40-46. [PMID: 31270093 PMCID: PMC6951236 DOI: 10.1136/archdischild-2019-317073] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2019] [Revised: 06/16/2019] [Accepted: 06/18/2019] [Indexed: 01/21/2023]
Abstract
BACKGROUND AND OBJECTIVES Adolescent sexual and reproductive health and rights (SRHR) are of particular relevance given their potential short-term or long-term health consequences. This study evaluates recommendations and policies regarding access to care in this area in 31 European countries (European Union (EU) plus Iceland, Norway and Switzerland). METHODS As part of the EU funded Models of Child Health Appraised project, data were gathered using a 43-item questionnaire sent to experts responsible for collecting information in each country. RESULTS Ten countries have not developed any formal policy or recommendation that guarantee the respect of confidentiality and the possibility of consulting a physician without parents knowing. Nearly half of the countries do not have centres specialised in adolescent healthcare, tackling comprehensive health issues or focusing specifically on SRH. Access to emergency contraception and information regarding pregnancy, including testing, is easy in most countries. However, oral contraception is delivered free of charge in only 10 countries. Twenty-three countries do not meet current standards in terms of providing policy-based pregnancy care, and only 13 have set up special programmes for pregnant adolescents. In only seven countries can adolescents definitely have their pregnancy terminated without their parents knowing (and in another seven countries in selected situations). CONCLUSION The provision and availability of adolescent-friendly SRHR care are far from optimal in around half of the surveyed countries. These results call for the review and implementation of policies, specialised healthcare centres and training initiatives for primary care providers.
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Affiliation(s)
| | - Annemieke Visser
- Department of Health Sciences, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Johanna Vervoort
- Department of Health Sciences, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Paul Kocken
- Department Public Health and Primary Care, TNO, Department Child Health, Leiden University Medical Centre, Leiden, The Netherlands
| | | | - Mitch Blair
- Paediatrics, Imperial College London, Harrow, UK
| | | | | | - Martin Weber
- WHO Regional Office for Europe, WHO, Copenhagen, Denmark
| | - Danielle Jansen
- Department of Health Sciences, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
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Michaud PA, Weber MW, Namazova-Baranova L, Ambresin AE. Improving the quality of care delivered to adolescents in Europe: a time to invest. Arch Dis Child 2019; 104:214-216. [PMID: 29599165 DOI: 10.1136/archdischild-2017-314429] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2017] [Revised: 03/07/2018] [Accepted: 03/10/2018] [Indexed: 11/03/2022]
Affiliation(s)
- Pierre-André Michaud
- Adolescent Medicine and Health, Lausanne University Hospital, Lausanne, Switzerland
| | - Martin W Weber
- Child and Adolescent Health, World Health Organization Regional Office for Europe, Copenhagen, Denmark
| | - Leyla Namazova-Baranova
- Department of Pediatrics, Scientific Centre of Children's Health, Russian State Medical University, Moscow, Russia
| | - Anne-Emmanuelle Ambresin
- Interdisciplinary Division for Adolescent Health, Lausanne University Hospital, Lausanne, Switzerland
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An exploratory survey on the state of training in adolescent medicine and health in 36 European countries. Eur J Pediatr 2019; 178:1559-1565. [PMID: 31463767 PMCID: PMC6733827 DOI: 10.1007/s00431-019-03445-1] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2019] [Revised: 07/18/2019] [Accepted: 08/06/2019] [Indexed: 11/11/2022]
Abstract
The development of adolescent health and medicine as a medical discipline lags behind in Europe compared with other regions of the world. This study aims to evaluate the structure and content of adolescent medicine and health training curricula for medical students, paediatricians, and other primary care physicians in the European region. A questionnaire survey was sent by e-mail to experts in the field from 36 European countries, addressing the content of adolescent health issues. Data was obtained from all 36 countries. At the undergraduate level, seven countries reported some mandatory stand-alone teaching (sessions dealing specifically with adolescents), while seven countries reported optional stand-alone teaching. In only 7 out of 36 countries were issues critical to adolescents covered as stand-alone sessions. At the postgraduate level, 15 countries delivered stand-alone mandatory training sessions to primary, secondary, or tertiary care paediatricians, covering most of the five critical areas listed in the questionnaire. In another 13 countries, such sessions were not mandatory and were inexistent in eight of them. The coverage among school physicians was similar but was much lower among general practitioners.Conclusion: Paediatric associations and academic institutions should advocate for a better coverage of adolescent health and medicine in the training curricula of health care providers. What is known: • In most European countries, adolescent medicine is still poorly represented as a discipline. • Experts have recently published recommendations regarding what form the structure and content of a training curriculum in this field should take. What is new: • This paper gives information on the extent and content of training in adolescent medicine and health as currently offered within under- and postgraduate European training curricula, in terms of stand-alone mandatory (versus optional) sessions. • In many European countries, both medical students and residents are poorly exposed to the basic knowledge and skills pertaining to adolescent health care.
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6
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Child and adolescent health in Europe: monitoring implementation of policies and provision of services. THE LANCET CHILD & ADOLESCENT HEALTH 2018; 2:891-904. [DOI: 10.1016/s2352-4642(18)30286-4] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/06/2018] [Revised: 08/15/2018] [Accepted: 08/21/2018] [Indexed: 11/17/2022]
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7
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Hughes N, Stark D. The management of adolescents and young adults with cancer. Cancer Treat Rev 2018; 67:45-53. [PMID: 29753962 DOI: 10.1016/j.ctrv.2018.05.001] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2018] [Revised: 05/03/2018] [Accepted: 05/04/2018] [Indexed: 12/11/2022]
Abstract
Adolescents and Young Adults (AYA) with cancer are young people developing serious illness when at the interface between the responsibilities of paediatric and adult cancer services. Personally, they are in a period of transition both biologically and in major social roles (Sawyer et al., 2018) [1]. For these and other reasons they present a unique set of clinical challenges in their management. Over the last 20 years the requirement for specific services to address their needs has been identified and this has become a growing field of research. Despite this survival rates still lag behind those of children and older adults with cancer (Gatta et al., 2009) [2]. Why do AYA patients have worse outcomes? The observation is that the reason is multifactorial with path to diagnosis, unique cancer biology, uncertainty of treatment protocol, compliance issues and poor recruitment to clinical trials all playing a part. In this review we will discuss the unique challenges faced by healthcare professionals when managing AYA patients who are commonly and accurately described as being in an 'interface' position.
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Affiliation(s)
- Nicola Hughes
- Leeds Institute of Cardiovascular and Molecular Medicine, University of Leeds, UK.
| | - Dan Stark
- Leeds Institute of Cancer and Pathology, St James's Institute of Oncology, Beckett Street, Leeds, UK
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8
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Michaud PA, Schrier L, Ross-Russel R, van der Heijden L, Dossche L, Copley S, Alterio T, Mazur A, Dembinski L, Hadjipanayis A, Del Torso S, Fonseca H, Ambresin AE. Paediatric departments need to improve residents' training in adolescent medicine and health: a position paper of the European Academy of Paediatrics. Eur J Pediatr 2018; 177:479-487. [PMID: 29270826 DOI: 10.1007/s00431-017-3061-2] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2017] [Revised: 11/27/2017] [Accepted: 11/29/2017] [Indexed: 11/28/2022]
Abstract
UNLABELLED In many European countries, paediatric junior staff has no formal training in adolescent medicine and is ill-equipped to deal with issues and health problems such as substance use, unprotected sex, eating disorders and transition to adult care. This position paper of the European Academy of Paediatrics proposes a set of competency-based training goals and objectives as well as pedagogic approaches that are expected to improve the capacity of paediatricians to meet the needs of this important segment of the paediatric population. The content has been developed from available publications and training programmes and mostly covers the generic aspects of adolescent healthcare, such as how to communicate effectively, how to review and address lifestyles, how to perform a respectful and relevant physical examination, how to address common problems of adolescents and how to support adolescents in coping with a chronic condition. CONCLUSION The European Academy of Paediatrics urges national bodies, paediatric associations and paediatric teaching departments to adopt these training objectives and put them into practice, so that paediatricians will be better prepared in the future to meet the challenge of delivering appropriate and effective healthcare to adolescents.
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Affiliation(s)
| | - Lenneke Schrier
- Department of Pediatrics, Leiden University Medical Centre, Leiden, Netherlands
| | | | - Laila van der Heijden
- Department of Pediatrics, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Lien Dossche
- Department of Pediatrics and Medical Genetics, Ghent University, Ghent, Belgium
| | - Sian Copley
- Neonatal Unit, Royal Victoria Infirmary, Upon Tyne, Newcastle, UK
| | - Tommaso Alterio
- Hepatology, Gastroenterology and Nutrition Unit, Bambino Gesù Children's Hospital, Rome, Italy.,National Observatory for Trainees and Young Paediatricians, ONSP, Padua, Italy
| | - Artur Mazur
- Medical Faculty, University of Rzeszow, Rzeszów, Poland
| | - Lukasz Dembinski
- Department of Paediatric Gastroenterology and Nutrition Medical University of Warsaw, Warsaw, Poland
| | - Adamos Hadjipanayis
- Faculty of Medicine, Cyprus & Paediatric Department, Larnaca General Hospital, European University of Cyprus, Engomi, Cyprus
| | | | - Helena Fonseca
- Adolescent Medicine Division, Department of Paediatrics, University Hospital Santa Maria, Lisbon, Portugal
| | - Anne-Emmanuelle Ambresin
- Interdisciplinary Division for Adolescent Health (DISA), University Hospital of Lausanne, Lausanne, Switzerland
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9
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Wright RJ, Howard EJ, Newbery N, Gleeson H. 'Training gap' - the present state of higher specialty training in adolescent and young adult health in medical specialties in the UK. Future Healthc J 2017; 4:80-95. [PMID: 31098440 PMCID: PMC6502624 DOI: 10.7861/futurehosp.4-2-80] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Young people often experience worse health outcomes and more dissatisfaction with healthcare compared with other age groups. This survey sought to determine the state of adolescent and young adult health training across medical specialties in the UK. An online questionnaire was distributed to higher specialty trainees in adult medical specialties. Training in adolescent/young adult health/transition was rated as minimal/non-existent by 70/73% of respondents, respectively; 52% reported that they had received no formal training and 61% had never attended a dedicated young person's or transition clinic. The most significant barrier to delivering good adolescent and young adult healthcare was felt to be lack of training to deal with adolescent issues. This survey has identified a 'training gap'; a lack of preparation to meet the specific care needs of the adolescent and young adult population. Improved interventions are required to help drive improvement in care for young people in the UK.
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Affiliation(s)
| | | | - Nina Newbery
- Medical Workforce Unit, Royal College of Physicians, London, UK
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10
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A European Society of Paediatric and Neonatal Intensive Care (ESPNIC) survey of European critical care management of young people. Eur J Pediatr 2017; 176:155-161. [PMID: 27995360 DOI: 10.1007/s00431-016-2815-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2016] [Revised: 11/02/2016] [Accepted: 11/03/2016] [Indexed: 10/20/2022]
Abstract
UNLABELLED Adolescents have specific healthcare needs distinct from adults or younger children secondary to anatomical, physiological and socio-behavioural differences. Healthcare providers have been slow to address this, leading the UK Department of Health (2011) to publish 'You're Welcome' quality criteria for services for young people. (In the UK, the term young people is preferred to adolescent.) These generic criteria poorly fit the critical care environment, omitting key issues whilst insisting upon irrelevant standards. But as young people are infrequent patients for any individual unit, the research base to guide optimal management is poor and we could find no international or national guidance. Together with the hospital's young people's group, our intensive care team identified six areas important for critically ill young people, which are the 6Ps: privacy, permission, deep vein thrombosis (DVT) prophylaxis, personal life, puberty and practical issues. We then surveyed practice across Europe regarding these themes. Fifty-four hospitals from 16 countries participated, demonstrating disparate practice and widely differing policies to meet the requirements of critically ill young people. CONCLUSION There is little consistency of practice in some areas such as pregnancy testing, DVT prophylaxis or partner visiting, whereas in others, such as involving young people in healthcare decisions where possible, practice is consistently good. Further research should focus on the young people's experience of critical care to refine healthcare policy. What is Known: • Adolescents have distinct health and psychosocial needs that are often poorly catered for in contemporary healthcare settings, including critical care. • As adolescents are infrequent patients for any intensive care unit, there is a poor research base and essentially no guidance, regarding optimal care. What is New: • We developed a mnemonic with adolescents and ICU staff to improve healthcare delivery to young people in critical care, the 6Ps: privacy, permission, DVT prophylaxis, personal life, puberty and practical issues. • Delivery of the adolescents' critical care varies greatly both between and within countries; the 6Ps offers a method of standardising and improving this across different countries.
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11
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Rutishauser C, Sawyer SM, Ambresin AE. Transition of young people with chronic conditions: a cross-sectional study of patient perceptions before and after transfer from pediatric to adult health care. Eur J Pediatr 2014; 173:1067-74. [PMID: 24610395 DOI: 10.1007/s00431-014-2291-9] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2013] [Revised: 02/07/2014] [Accepted: 02/17/2014] [Indexed: 10/25/2022]
Abstract
UNLABELLED The aim of this study was to compare perceived barriers to and the most preferred age for successful transition to adult health care between young people with chronic disorders who had not yet transferred from pediatric to adult health care (pre-transfer) and those who had already transferred (post-transfer). In a cross-sectional study, we compared 283 pre-transfer with 89 post-transfer young people, using a 28-item questionnaire that focused on perceived barriers to transition and beliefs about the most preferred age to transfer. Feeling at ease with the pediatrician was the most important barrier to successful transition in both groups, but was rated significantly higher in the pre-transfer compared to the post-transfer group (OR = 2.03, 95 %CI 1.12-3.71). Anxiety and lack of information were the next most important barriers, rated equally highly by the two groups (OR = 0.67, 95 %CI 0.35-1.28 and OR = 0.71, 95 %CI 0.36-1.38, respectively). More than 80 % of the respondents in both groups reported that 16-19 years was the most preferred age to transfer; more than half of all the respondents reported 18-19 years and older as the most preferred age. CONCLUSION Better transition planning through the provision of regular and more detailed information about adult health-care providers and the transition process could reduce anxiety and contribute to a more positive attitude to overcome perceived barriers to transition from young people's perspective. Young people's preferences about transferring to adult health care provide a challenge to those children's hospitals that transfer to adult health care at a younger age.
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Affiliation(s)
- Christoph Rutishauser
- Head Adolescent Medicine Unit, University Children's Hospital, Steinwiesstrasse 75, 8032, Zurich, Switzerland,
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12
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Voices not heard: A systematic review of adolescents' and emerging adults' perspectives of health care transition. Nurs Outlook 2013; 61:311-36. [DOI: 10.1016/j.outlook.2013.01.008] [Citation(s) in RCA: 92] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2012] [Revised: 01/23/2013] [Accepted: 01/28/2013] [Indexed: 11/20/2022]
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Tattersall RS, McMahon AM. The MAGICC and practical approach to rheumatology transition. Br J Hosp Med (Lond) 2012; 73:552-7. [DOI: 10.12968/hmed.2012.73.10.552] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
| | - Anne-Marie McMahon
- Paediatric and Adolescent Rheumatology, Sheffield Childrens Hospital, Sheffield
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14
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Rutishauser C, Akré C, Surìs JC. Transition from pediatric to adult health care: expectations of adolescents with chronic disorders and their parents. Eur J Pediatr 2011; 170:865-71. [PMID: 21174123 DOI: 10.1007/s00431-010-1364-7] [Citation(s) in RCA: 51] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2010] [Revised: 11/18/2010] [Accepted: 11/23/2010] [Indexed: 01/15/2023]
Abstract
The aim of this study was to assess the expectations of adolescents with chronic disorders with regard to transition from pediatric to adult health care and to compare them with the expectations of their parents. A cross-sectional study was carried out including 283 adolescents with chronic disorders, aged 14-25 years (median age, 16.0 years), and not yet transferred to adult health care, and their 318 parents from two university children's hospitals. The majority of adolescents and parents (64%/70%) perceived the ages of 18-19 years and older as the best time to transfer to adult health care. Chronological age and feeling too old to see a pediatrician were reported as the most important decision factors for the transfer while the severity of the disease was not considered important. The most relevant barriers were feeling at ease with the pediatrician (45%/38%), anxiety (20%/24%), and lack of information about the adult specialist and health care (18%/27%). Of the 51% of adolescents with whom the pediatric specialist had spoken about the transfer, 53% of adolescents and 69% of parents preferred a joint transfer meeting with the pediatric and adult specialist, and 24% of these adolescents declared that their health professional had offered this option. In summary, the age preference for adolescents with chronic disorders and their parents to transfer to adult health care was higher than the upper age limits for admission to pediatric health care in many European countries. Anxiety and a lack of information of both adolescents and their parents were among the most important barriers for a smooth and timely transfer according to adolescents and parents.
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Affiliation(s)
- Christoph Rutishauser
- Adolescent Medicine Unit, University Children's Hospital Zurich, Zurich, Switzerland.
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Davison B, Cunningham T, Singh G. Engaging adolescents and young adults in a longitudinal health study: experience from the Top End cohort. Aust N Z J Public Health 2011; 35:86-7. [PMID: 21299708 DOI: 10.1111/j.1753-6405.2010.00666.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Hagen B, Strauch S. The J1 adolescent health check-up: analysis of data from the German KiGGS survey. DEUTSCHES ARZTEBLATT INTERNATIONAL 2011; 108:180-6. [PMID: 21475566 DOI: 10.3238/arztebl.2011.0180] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/18/2010] [Accepted: 05/18/2010] [Indexed: 11/27/2022]
Abstract
BACKGROUND We analyzed data from the Robert Koch Institute's KiGGS survey regarding the J1 adolescent health check-up in order to determine what information this check-up provides. METHODS Descriptive statistical analysis of J1 participation with respect to social, demographic, medical and psychological factors, with logistic regression analysis of the risk associated with non-participation. RESULTS 32.9% of all adolescents in Germany aged 14 to 17 had a J1 check-up. Thus, the J1 participation rate has remained low since the introduction of the J1 in Germany. The main conditions that were more commonly found in adolescents who had a J1 check-up were thyroid disorders (4.1% vs. 2.9%), and scoliosis (14.8% vs. 10.5%). Adolescents were only half as likely to have a J1 check-up if they were under the care of a general practitioner, rather than a pediatrician (odds ratio [OR] 0.46, 95% confidence interval [CI] 0.36-0.60). Foreign adolescents were only half as likely to have a J1 check-up as German ones (OR 0.51, 95% CI 0.31-0.84). CONCLUSION There is compelling evidence that scoliosis and thyroid disorders, in particular, are underdiagnosed if a J1 check-up is not performed. Thus, elevating the J1 participation rate should be a priority. If a J1-check up were performed in the nearly two-thirds of all adolescents who currently do not undergo one, many latent health problems could be recognized and treated in timely fashion.
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Affiliation(s)
- Bernd Hagen
- Zentralinstitut für die Kassenärztliche Versorgung, Köln, Germany.
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17
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Adolescent medicine in Europe: integration and cooperation are needed. Eur J Pediatr 2009; 168:885-7; author reply 889. [PMID: 18936969 DOI: 10.1007/s00431-008-0854-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2008] [Accepted: 10/01/2008] [Indexed: 10/21/2022]
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