THE TRANSITION OF ADOLESCENTS TO ADULT NEPHROLOGY CARE: A SURVEY ON YOUNG ADULTS’ EXPERIENCE

Year 2022, Volume: 85 Issue: 1, 86 - 90, 25.01.2022

Neslihan Çiçek , Harika Alpay

https://doi.org/10.26650/IUITFD.910335

Abstract

Objective: As increasing number of young people with renal diseases are reaching adulthood and issues related to their transition to adult units are getting more important. Failure to transfer adolescents under a well-designed transfer program can lead to a decline in attendance to an adult unit. We aim to share our experience and the views of the patients who went through a transition program. Material and Methods: We conducted a telephone questionnaire with 88 patients, who were asked to evaluate their concerns before their transition and their experience during the visit in the adult nephrology unit after the transition process. Results: The mean age of participants was 19.21±0.97 years. Thirty patients (34%) had chronic kidney disease, and three of them were on dialysis. Three patients (3.4%) had a renal transplant at the time of transition. Fifty-one patients (58%) were felt anxious before the transition process. After their transfer to the adult unit, although 84 patients (95.5%) were satisfied to be in the adult unit, there were still 65 patients (74%) ready to return to the pediatric unit, if it was possible. Conclusion: Transition to the adult unit is still a cause of concern for adolescent patients, even if they are transferred under a well-designed program. It is important to raise awareness about transition programs among pediatricians and to develop a pediatric- adult transition program for the medical and psychological well-being of patients.

Keywords

Adolescence, pediatrics, questionnaire, transition

ADOLESAN HASTALARIN ERİŞKİN NEFROLOJİ BÖLÜMÜNE DEVREDİLMESİ: GENÇ YETİŞKİNLERİN DENEYİMLERİ

Abstract

Amaç: Böbrek hastalığı olan daha fazla sayıda genç hastanın erişkin dönemine ulaşmasıyla, bu hastaların erişkin bölümlerine devredilmesi de giderek önem kazanmaktadır. İyi planlanmış bir program ile devredilmeyen hastalarda erişkin bölümüne uyumda azalma görülebilir. Bu çalışmada devir programı ile erişkin bölümüne geçen hastaların tecrübe ve fikirlerini paylaşmayı hedefledik. Gereç ve Yöntem: Seksen sekiz hastaya devir öncesi endişelerini ve devir süreci sonrasında erişkin nefroloji ünitesine ziyaret deneyimlerini değerlendiren bir telefon anketi uyguladık. Bulgular: Hastaların ortalama yaşı 19,21±0,97 yıl idi. Erişkin bölümüne devir sırasında, otuz hasta (%34) kronik böbrek hastalığı ile izlenmekteydi, bu hastaların üçü (%3.4) diyaliz tedavisi alırken, üçü (%3,4) böbrek nakilliydi. Elli bir hasta (%58) devir öncesi endişeli olduğunu belirtti. Erişkin bölümüne ziyaretleri sonrasında, 84 hasta (%95,5) erişkin bölümündeki takipten memnun olduğunu belirtmesine rağmen, 65 hasta (%74) mümkün olsa yine de çocuk bölümüne geri dönmek istediklerini belirtti. Sonuç: İyi tasarlanmış bir programla erişkin bölümüne geçmiş olsalar bile, devir adolesan hastalar için hala bir endişe kaynağıdır. Çocuk doktorları arasında devir programları hakkında farkındalık yaratmak ve hastaların tıbbi ve psikolojik iyiliği için bir pediyatrik- yetişkin devir programı geliştirmek önemlidir.

Keywords

Adolesan, pediatri, anket, devir

References

• 1. O’Leary C, Wieneke P, Healy M, Cronin C, O’Regan P, Shanahan F. Celiac disease and the transition from childhood to adulthood: a 28-year follow-up. Am J Gastroenterol 2004;99(12):2437-41. [CrossRef]
• 2. Khan A, Baheerathan A, Hussain N, Whitehouse W. Transition of children with epilepsies to adult care. Acta Paediatr 2013;102(3):216-21. [CrossRef]
• 3. Srivastava SA, Elkin SL, Bilton D. The transition of adolescents with chronic respiratory illness to adult care. Paediatr Respir Rev 2012;13(4):230-5. [CrossRef]
• 4. Alpay H. Transition of the adolescent patient to the adult clinic. Perit Dial Int 2009;29(Suppl 2):180-2. [CrossRef]
• 5. Ishizaki Y, Maru M, Higashino H, Katsumoto S, Egawa K, Yanagimoto Y, Nagahama T. The transition of adult patients with childhood-onset chronic diseases from pediatric to adult healthcare systems: a survey of the perceptions of Japanese pediatricians and child health nurses. Biopsychosoc Med 2012;6:8. [CrossRef]
• 6. Cooley WC, Sagerman PJ. Supporting the health care transition from adolescence to adulthood in the medical home. Pediatrics 2011;128(1):182-200. [CrossRef]
• 7. Crowley R, Wolfe I, Lock K, McKee M. Improving the transition between paediatric and adult healthcare: a systematic review. Arch Dis Child 2011;96(6):548-53. [CrossRef]
• 8. Watson AR. Non-compliance and transfer from paediatric to adult transplant unit. Pediatr Nephrol 2000;14(6):469-72. [CrossRef]
• 9. Camfield PR, Andrade D, Camfield CS, Carrizosa-Moog J, Appleton R, Baulac M, et al. How can transition to adult care be best orchestrated for adolescents with epilepsy? Epilepsy Behav 2019;93:138-47. [CrossRef]
• 10. Watson AR, Harden P, Ferris M, Kerr PG, Mahan J, Ramzy MF. Transition from pediatric to adult renal services: a consensus statement by the International Society of Nephrology (ISN) and the International Pediatric Nephrology Association (IPNA). Pediatr Nephrol 2011;26(10):1753-7. [CrossRef]
• 11. Ferris ME, Cuttance JR, Javalkar K, Cohen SE, Phillips A, Bickford K, et al. Self-management and transition among adolescents/young adults with chronic or end-stage kidney disease. Blood Purif 2015;39(1-3):99-104. [CrossRef]
• 12. Bell L. Adolescent dialysis patient transition to adult care: a cross-sectional survey. Pediatr Nephrol 2007;22(5):720-6. [CrossRef]
• 13. Weitz M, Heeringa S, Neuhaus TJ, Fehr T, Laube GF. Standardized multilevel transition program: Does it affect renal transplant outcome? Pediatr Transplant 2015;19(7):691-7. [CrossRef]
• 14. Tuffrey C, Pearce A. Transition from paediatric to adult medical services for young people with chronic neurological problems. J Neurol Neurosurg Psychiatry 2003;74(8):1011-3. [CrossRef]
• 15. Tong A, Wong G, Hodson E, Walker RG, Tjaden L, Craig JC. Adolescent views on transition in diabetes and nephrology. Eur J Pediatr 2013;172(3):293-304. [CrossRef]
• 16. Catena G, Rempel GR, Kovacs AH, Rankin KN, Muhll IV, Mackie AS. “Not such a kid thing anymore”: Young adults’ perspectives on transfer from paediatric to adult cardiology care. Child Care Health Dev 2018;44(4):592-8. [CrossRef]