Evaluation of Effective Transition from Pediatric to Adult Care in Type I Diabetes PDF Download
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Author: Teresa M. Chamorro
Publisher:
ISBN:
Category : Diabetes in adolescence
Languages : en
Pages : 110
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Book Description
Adolescents with chronic medical conditions experience complex and vast medical and psychological problems as a result of poor transition from pediatric to adult medical care. Inadequate transition results in loss to follow up, reduced clinic attendance, and limited contact with health care providers. This ultimately results in poor health outcomes and increased morbidity and mortality, as individuals between twenty and twenty-nine with type I diabetes have higher death rates than any other age group. Several barriers have been identified as directly impacting adequate transition including, individual patient factors, developmental and emotional barriers, and systemic barriers. Additionally, in 2014, approximately 14.4 billion dollars were spent in direct medical costs and reduced productivity secondary to complications of type I diabetes. The aim of my study is to evaluate and delineate specific elements of transition programs and interventions, both nationally and internationally, that have been effective in improving diabetes-specific outcomes for adolescents with type 1 diabetes. This study will also delineate individual risk factors that precipitate and exacerbate poor diabetes management, as well as the impact that implementing such interventions would have on overall health care expenditure.
Author: Teresa M. Chamorro
Publisher:
ISBN:
Category : Diabetes in adolescence
Languages : en
Pages : 110
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Book Description
Adolescents with chronic medical conditions experience complex and vast medical and psychological problems as a result of poor transition from pediatric to adult medical care. Inadequate transition results in loss to follow up, reduced clinic attendance, and limited contact with health care providers. This ultimately results in poor health outcomes and increased morbidity and mortality, as individuals between twenty and twenty-nine with type I diabetes have higher death rates than any other age group. Several barriers have been identified as directly impacting adequate transition including, individual patient factors, developmental and emotional barriers, and systemic barriers. Additionally, in 2014, approximately 14.4 billion dollars were spent in direct medical costs and reduced productivity secondary to complications of type I diabetes. The aim of my study is to evaluate and delineate specific elements of transition programs and interventions, both nationally and internationally, that have been effective in improving diabetes-specific outcomes for adolescents with type 1 diabetes. This study will also delineate individual risk factors that precipitate and exacerbate poor diabetes management, as well as the impact that implementing such interventions would have on overall health care expenditure.
Author: Helen M. Parsons
Publisher:
ISBN:
Category :
Languages : en
Pages : 0
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Book Description
OBJECTIVE: To understand the evidence base for care interventions, implementation strategies, and between-provider communication tools among children with special healthcare needs (CSHCN) transitioning from pediatric to adult medical care services. DATA SOURCES: We searched Ovid MEDLINE(r), Ovid Embase(r), the Cochrane Central trials (CENTRAL) registry, and CINAHL(r) to identify studies through September 10, 2021. We conducted grey literature searches to identify additional resources relevant to contextual questions. REVIEW METHODS: Using a mixed-studies review approach, we searched for interventions or implementation strategies for transitioning CSHCN from pediatric to adult services. Two investigators screened abstracts and full-text articles of identified references for eligibility. Eligible studies included randomized controlled trials, quasi-experimental observational studies, and mixed-method studies of CSHCN, their families, caregivers, or healthcare providers. We extracted basic study information from all eligible studies and grouped interventions into categories based on disease conditions. We summarized basic study characteristics for included studies and outcomes for studies assessed as low to medium risk of bias using RoB-2. RESULTS: We identified 9,549 unique references, 440 of which represented empirical research; of these, 154 (16 major disease categories) described or examined a care transition intervention with enough detail to potentially be eligible for inclusion in any of the Key Questions. Of these, 96 studies met comparator criteria to undergo risk of bias assessment; however only 9 studies were assessed as low or medium risk of bias and included in our analytic set. Low-strength evidence shows transition clinics may not improve hemoglobin A1C levels either at 12 or 24 months in youth with type 1 diabetes mellitus compared with youth who received usual care. For all other interventions and outcomes, the evidence was insufficient to draw meaningful conclusions because the uncertainty of evidence was too high. Some approaches to addressing barriers include dedicating time and resources to support transition planning, developing a workforce trained to care for the needs of this population, and creating structured processes and tools to facilitate the transition process. No globally accepted definition for effective transition of care from pediatric to adult services for CSHCN exists; definitions are often drawn from principles for transitions, encompassing a broad set of clinical aspects and other factors that influence care outcomes or promote continuity of care. There is also no single measure or set of measures consistently used to evaluate effectiveness of transitions of care. The literature identifies a limited number of available training and other implementation strategies focused on specific clinical specialties in targeted settings. No eligible studies measured the effectiveness of providing linguistically and culturally competent healthcare for CSHCN. Identified transition care training, and care interventions to prepare pediatric patients and their families for transitioning from CSHCN to adult care, varied considerably. CONCLUSIONS: Little rigorous evidence exists to inform care interventions and implementation strategies. Significant barriers impede implementation of interventions, tools, and trainings to transition CSHCN, which may be reduced in future intervention development. This review highlights the need for more rigorous studies across the diverse populations of CSHCN in order to provide clearer answers for CSHCN, their families, caregivers, providers, funders, and policymakers.
Author: Kirsten P.W. Seals
Publisher:
ISBN:
Category :
Languages : en
Pages : 38
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Book Description
Author: Albert C. Hergenroeder
Publisher: Springer
ISBN: 3319728687
Category : Medical
Languages : en
Pages : 386
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Book Description
This comprehensive book thoroughly addresses all aspects of health care transition of adolescents and young adults with chronic illness or disability; and includes the framework, tools and case-based examples needed to develop and evaluate a Health Care Transition (HCT) planning program that can be implemented regardless of a patient’s disease or disability. Health Care Transition: Building a Program for Adolescents and Young Adults with Chronic Illness and Disability is a uniquely inclusive resource, incorporating youth/young adult, caregiver, and pediatric and adult provider voices and perspectives. Part I of the book opens by defining Health Care Transition, describing the urgent need for comprehensive transition planning, barriers to HCT and then offering a framework for developing and evaluating health care transition programs. Part II focuses on the anatomic and neuro-chemical changes that occur in the brain during adolescence and young adulthood, and how they affect function and behavior. Part III covers the perspectives of important participants in the HCT transition process – youth and young adults, caregivers, and both pediatric and adult providers. Each chapter in Part IV addresses a unique aspect of developing HCT programs. Part V explores various examples of successful transition from the perspective of five key participants in the transition process - patients, caregivers, pediatric providers, adult providers and third party payers. Related financial matters are covered in part VI, while Part VII explores special issues such as HCT and the medical home, international perspectives, and potential legal issues. Models of HCT programs are presented in Part VIII, utilizing an example case study. Representing perspectives from over 75 authors and more than 100 medical centers in North America and Europe, Health Care Transition: Building a Program for Adolescents and Young Adults with Chronic Illness and Disability is an ideal resource for any clinician, policy maker, caregiver, or hospitalist working with youth in transition.
Author: M. Polak
Publisher: Karger Medical and Scientific Publishers
ISBN: 3318061433
Category : Medical
Languages : en
Pages : 170
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Book Description
Pediatricians face many questions and challenges during patients’ transition from childhood to adulthood. Chronic diseases justify long-term medical, psychological, educational, and social management. The establishment of networks with adult endocrinologists is, therefore, very important to achieving optimal conditions for a successful transition period. In this book, leading experts discuss major public health issues such as diabetes and obesity. They also review genetic diseases, including Turner syndrome and congenital adrenal hyperplasia. All clinical cases are presented in a focused way to highlight any issues which might be discussed by the doctor with patients and family. Psychological approaches are debated as are proposals for defining specific tools to encourage autonomy during this life period. This book is a valuable tool and will be helpful in answering many questions for endocrinologists, adult and pediatric, dedicated to the long-term management of patients with chronic diseases.
Author: Cecily L. Betz
Publisher: Springer Nature
ISBN: 3030233847
Category : Medical
Languages : en
Pages : 344
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Book Description
This book offers essential information on interventions and actions that enable and promote transition experiences for adolescents and young adults. It provides guidance on appropriate strategies that bring together these groups and caregivers in the context of transition preparation, and those which optimize adolescents’ and young adults’ ability to self-manage their healthcare. The health care transition for adolescents and young adults has gained more attention given the improved survival rates, including for those with long-term conditions. It is now estimated that more than 90% of children diagnosed with a long-term condition will survive into adulthood. The significant change in survival requires concomitant services to facilitate adolescents’ and young adults’ successful transition to adult health care, therefore providers need education, knowledge and skills to support healthcare transition services. A recent US national survey demonstrated only 10% of parents/caregivers reported that their children received transition preparation services. This book is targeted at nurses and pediatric and adult health care providers of different disciplines seeking guidance on which interventions are available, how they can be used, advantages and challenges, and how best to promote a seamless transition for all adolescents and young adults with long-term conditions. It provides several examples of transition programmes and initiatives worldwide. There is an increasing focus on how nurses can support transition but little guidance on what is effective and what has been tried. This book will fill a gap by addressing all of these issues outlined above and by providing worked examples from leading nurse researchers and academics worldwide.
Author: Sarah K. Lyons
Publisher: Springer
ISBN: 3030050459
Category : Medical
Languages : en
Pages : 236
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Book Description
This unique handbook provides pediatric and adult endocrinologists and multidisciplinary clinical care providers a guide to transition from pediatric to adult care and an understanding of developmental and psychosocial issues of young adulthood and how they relate to healthcare and disease self-management. The handbook is divided into two parts. Part one describes transition interventions and novel strategies that can be integrated into routine care and gives practical considerations for transition processes from both the pediatric and adult perspectives, with applications across multiple endocrine conditions. Part two focuses on transition issues specific to common endocrine conditions – type 1 and type 2 diabetes, Turner syndrome, congenital adrenal hyperplasia, endocrine sequelae of childhood cancer, and transgender care – with condition-specific developmental and psychosocial issues, treatment and screening recommendations, healthcare process considerations, transition care guidelines, and key resources for more information. By highlighting medical, psychosocial, and healthcare delivery concerns relevant to transition to adult care, this book provides a practical, patient-centered overview of the essential information to supporting optimal adult care transition across a number of endocrine conditions. Timely and practical, Transitioning from Pediatric to Adult Care in Endocrinology: A Clinical Handbook is an excellent resource for pediatric and adult endocrinologists, behavioral healthcare providers, allied health professionals, primary care providers, and all clinical staff working with young people with endocrine conditions as they transition from children to adults.
Author: N. Tehrani
Publisher:
ISBN:
Category :
Languages : en
Pages : 17
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Book Description
Background : Type 1 Diabetes Mellitus is one of the most common chronic diseases in the pediatric population. Complications arising from inadequate follow up and treatment not only represent a disruption to care but also result in significant increases in the morbidity and mortality of such patients. One particular challenge faced by pediatric healthcare practitioners is the inevitable need to transfer care from the pediatric to the adult healthcare setting. Unsuccessful patient transfer results in the loss of appropriate care and an increase in the risk for adverse health outcomes. The main obstacles to the timely transfer of care are a lack of adequate patient preparedness for transfer of care and inadequate inter-physician networking/sharing of information in a culturally competent manner. Definition/Goals : Given these obstacles, this study stipulates that the provision of educational and networking resources to patients and adult care practitioners during the transition process will enable more effective transitioning from pediatric to adult care in T1DM patients. The main goal of this project is to create culturally appropriate transition tools and secondarily to identify and address obstacles to the process of educating patients and the establishment of networks among providers to the transitioning population. Methods/Materials : English and Spanish transition tools including patient and parent questionnaires, practitioner health summary tools, and transition brochure will be created. Materials will be reviewed by transition providers and clinic staff for effectiveness. Outcomes : These tools will then be made available to patients and practitioners through the Pediatric Endocrine clinic for immediate use in transitioning patients. The effectiveness of the transition tools will be assessed in follow up studies determining the percentage of transition teens scheduled and seen by their new providers and by feedback from both the transitioning population and their new providers.
Author: Nancy Lynn Olson
Publisher:
ISBN: 9781124617879
Category : Diabetes
Languages : en
Pages : 180
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Book Description
Abstract: The transition of children diagnosed with Type 1 diabetes mellitus (T1DM) into the adult diabetes care practice is often complicated, not only from the specificity of a pediatric illness but also the added stress of normal psychosocial transitions of the emerging adult and the family dynamics of a child with chronic illness. This survey provided information on what registered nurses and dieticians perceived as barriers to successful transition from pediatric to adult care and whether a dedicated facilitator would improve the overall health and glycemic control of young adult diabetics. Factors that affect the successful transition, identified from the research, are reviewed in this research paper. Suggestions for implementing guidelines for transition and follow-up care by a nurse practitioner are indicated. Guidance in transition by a familiar nurse practitioner, liaising between the pediatric and adult practices, will aid in reducing "dropping out" of medical care, and the costly complications of Type 1 diabetes.
Author: Howard A. Wolpert
Publisher: American Diabetes Association
ISBN: 1580403646
Category : Health & Fitness
Languages : en
Pages : 129
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Book Description
Providing care for a young adult with type 1 diabetes during this stage can be difficult as well. Transitions in Care serves as a coaching manual for health care providers and parents, and as a guide to self-care and independence for young adults with diabetes. It demystifies a complicated period in a life with type 1 diabetes and makes the passage to adulthood easier for everyone involved.
