从儿科到成人医疗保健提供者的护理转变:对年轻糖尿病患者的持续挑战和机遇。

Endocrine development Pub Date : 2018-01-01 Epub Date: 2018-06-08 DOI:10.1159/000487866
Katharine Garvey, Lori Laffel
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引用次数: 10

摘要

青春期和青年期是多种发育变化的时期,包括生理、社会、情感、认知和行为转变。患有1型或2型糖尿病的青少年或年轻人必须在处理这些条件的严峻性和自我保健需求的同时,驾驭这些发展阶段的变迁。儿童糖尿病由成年人管理,主要由父母管理。随着孩子的成熟,糖尿病管理的任务从父母转移到发展中的青少年。这种护理的过渡过程通常从青春期早期开始,当年龄较大的青少年成功地接受并管理糖尿病自我护理任务时达到高潮。随着糖尿病管理任务的转变,年龄较大的青少年和年轻人必须准备好从儿科糖尿病护理小组转移到以成人为中心的卫生保健小组。许多出版物描述了与过渡过程和转移行为有关的挑战。在转诊期间缺乏准备,随后转诊不成功,往往导致糖尿病护理间隔超过6个月,血糖控制恶化,急诊室使用率和住院率增加,并在年龄较大的青少年和年轻人中出现糖尿病并发症。国际上需要进行持续的研究,以解决这些不足,以改善青年糖尿病患者的短期和长期健康。
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Transitions in Care from Pediatric to Adult Health Care Providers: Ongoing Challenges and Opportunities for Young Persons with Diabetes.

Adolescence and young adulthood are times of multiple developmental changes, including physiological, social, emotional, cognitive, and behavioral transformations. The adolescent or young adult living with type 1 or type 2 diabetes must navigate the vicissitudes of these developmental stages while managing the rigors and self-care demands of these conditions. Diabetes in children is managed by adults, mainly by parents. As the child matures, diabetes management tasks transition from parents to the developing teen. This transition in care is a process that generally begins in early adolescence and culminates when the older teen successfully accepts and manages diabetes self-care tasks. Along with the transitions in diabetes management tasks, older teens and young adults must be prepared for transfer from the pediatric diabetes care team to an adult-focused health care team. Numerous publications have described the challenges associated with both the process of transition and the act of transfer. Lack of preparation during transition followed by unsuccessful transfer often results in gaps in diabetes care exceeding 6 months, deterioration in glycemic control, increase in emergency room use and hospitalization, and emergence of diabetes complications among older teens and young adults. There is need for ongoing research internationally to address these deficiencies in order to improve the short- and long-term health of young persons with diabetes.

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