How Adult Specialists Deal with the Principles of a Successful Transition
Received 23 February 2009; accepted 28 May 2009. published online 08 July 2009.
Refers to article:
Growing Up and Getting Old(er) With Childhood-Onset Chronic Diseases: Paving the Way to Better Chronic Illness Care Worldwide
Megumi J. Okumura
Journal of Adolescent Health
December 2009 (Vol. 45, Issue 6, Pages 541-542) Full Text |
Full-Text PDF (194 KB)
Abstract
Objectives
To evaluate whether adult specialists comply with the basic principles for a successful transition of adolescents with chronic disorders, and to determine whether the characteristics of the adult specialists have an influence on applying these principles.
Methods
Out of 299 adult specialists in four French-speaking Swiss cantons, 209 (70%) answered a paper-and-pencil mailed questionnaire between May and July 2007. Only those having received the transfer of at least one adolescent in the previous 2 years (N=102) were included in the analysis. We analyzed four dependent variables: discussing common concerns of adolescent patients, seeing the patient alone, having a transition protocol, and having a previous contact with the pediatric specialist. A logistic regression was performed for each dependent variable controlling for the physicians' characteristics (number of transfers, age, gender, workplace, and perceived experience).
Results
Fifty-four percent of the physicians did not spend time alone with their patients, and sensitive issues such as sexuality or substance use were not widely discussed with their young patients. Most respondents (59%) did not have an established protocol, and 54% did not have any contact with the pediatric specialist. In the multivariate analyses, the adult specialists' characteristics had little impact.
Conclusions
For many adolescents with chronic disorders the transition from pediatric to adult healthcare seems to be limited to a simple transfer, often lacking adequate communication between physicians. Applying simple but basic principles such as a good coordination between providers would probably improve the quality of healthcare of adolescents with chronic illness.
aResearch Group on Adolescent Health, Institute of Social and Preventive Medicine, University of Lausanne, Lausanne, Switzerland
bAdolescent Medicine Unit, University Children's Hospital, Zurich, Switzerland
Address correspondence to: Joan-Carles Suris, M.D., Ph.D., Research Group on Adolescent Health, Institute of Social and Preventive medicine, University of Lausanne, Bugnon 17, 1005 Lausanne, Switzerland.
ABSTRACT