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[PMID]:29406635
[Au] Autor:Monti MD
[Ti] Título:Growing Pains: Ethical Considerations for Transitioning to Adult Care with Childhood-Onset Conditions.
[So] Source:Pediatr Nurs;42(4):201-3, 2016 Jul-Aug.
[Is] ISSN:0097-9805
[Cp] País de publicação:United States
[La] Idioma:eng
[Mh] Termos MeSH primário: Doença Crônica/terapia
Transição para Assistência do Adulto/ética
Transição para Assistência do Adulto/organização & administração
[Mh] Termos MeSH secundário: Adolescente
Adulto
Seres Humanos
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180305
[Lr] Data última revisão:
180305
[Sb] Subgrupo de revista:N
[Da] Data de entrada para processamento:180207
[St] Status:MEDLINE


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[PMID]:28992855
[Au] Autor:Overholser L; Kilbourn K; Liu A
[Ad] Endereço:Division of General Internal Medicine, University of Colorado School of Medicine, 12631 East 17th Avenue, Mail Stop B180, Aurora, CO 80045, USA. Electronic address: linda.overholser@ucdenver.edu.
[Ti] Título:Survivorship Issues in Adolescent and Young Adult Oncology.
[So] Source:Med Clin North Am;101(6):1075-1084, 2017 Nov.
[Is] ISSN:1557-9859
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Adolescent and young adult (AYA) individuals with a history of cancer make up a fraction of the total number of cancer survivors in the United States, but they represent a population with needs distinct from either the childhood or the older adult cancer populations. Fertility concerns, psychosocial factors, and health care access are just a few of the distinguishing characteristics. Caring for AYA cancer survivors presents unique opportunities for primary care providers to collaborate with oncology colleagues to minimize the long-term cancer burden.
[Mh] Termos MeSH primário: Acesso aos Serviços de Saúde/organização & administração
Neoplasias/psicologia
Atenção Primária à Saúde/organização & administração
Sobreviventes/psicologia
Transição para Assistência do Adulto/organização & administração
[Mh] Termos MeSH secundário: Adolescente
Aconselhamento
Fertilidade
Promoção da Saúde
Seres Humanos
Saúde Mental
Neoplasias/complicações
Encaminhamento e Consulta
Estados Unidos
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171023
[Lr] Data última revisão:
171023
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:171011
[St] Status:MEDLINE


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[PMID]:28716320
[Au] Autor:Cardona-Grau D; Chiang G
[Ad] Endereço:Pediatric Urology, University of California San Diego, Rady Children's Hospital, 3020 Children's Way MC 5120, San Diego, CA 92123, USA.
[Ti] Título:Evaluation and Lifetime Management of the Urinary Tract in Patients with Myelomeningocele.
[So] Source:Urol Clin North Am;44(3):391-401, 2017 Aug.
[Is] ISSN:1558-318X
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:In the United States, there are an estimated 25,000 children ages 0 to 19 years and about 166,000 of all ages currently affected by spina bifida. Management is multimodal and can be complex. Management techniques vary throughout a child's lifetime, but the goals remain the same: prevention of urinary tract infections and establishing acceptable continence. Continence is addressed as the child reaches school age. Additional considerations such as development of urolithiasis and the associated burden are highlighted in adolescence and into adulthood. These complex medical needs become more challenging as patients age and need to transition to adult providers.
[Mh] Termos MeSH primário: Meningomielocele/complicações
Doenças Urológicas/diagnóstico
Doenças Urológicas/terapia
[Mh] Termos MeSH secundário: Adolescente
Adulto
Fatores Etários
Criança
Pré-Escolar
Seres Humanos
Lactente
Recém-Nascido
Vigilância da População
Transição para Assistência do Adulto
Doenças Urológicas/etiologia
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170803
[Lr] Data última revisão:
170803
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170719
[St] Status:MEDLINE


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[PMID]:28681381
[Au] Autor:Andrade DM; Bassett AS; Bercovici E; Borlot F; Bui E; Camfield P; Clozza GQ; Cohen E; Gofine T; Graves L; Greenaway J; Guttman B; Guttman-Slater M; Hassan A; Henze M; Kaufman M; Lawless B; Lee H; Lindzon L; Lomax LB; McAndrews MP; Menna-Dack D; Minassian BA; Mulligan J; Nabbout R; Nejm T; Secco M; Sellers L; Shapiro M; Slegr M; Smith R; Szatmari P; Tao L; Vogt A; Whiting S; Carter Snead O
[Ad] Endereço:Division of Neurology, Epilepsy Transition Program and Epilepsy Genetics Program, University of Toronto, Toronto Western Hospital, Toronto, Ontario, Canada.
[Ti] Título:Epilepsy: Transition from pediatric to adult care. Recommendations of the Ontario epilepsy implementation task force.
[So] Source:Epilepsia;58(9):1502-1517, 2017 Sep.
[Is] ISSN:1528-1167
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:The transition from a pediatric to adult health care system is challenging for many youths with epilepsy and their families. Recently, the Ministry of Health and Long-Term Care of the Province of Ontario, Canada, created a transition working group (TWG) to develop recommendations for the transition process for patients with epilepsy in the Province of Ontario. Herein we present an executive summary of this work. The TWG was composed of a multidisciplinary group of pediatric and adult epileptologists, psychiatrists, and family doctors from academia and from the community; neurologists from the community; nurses and social workers from pediatric and adult epilepsy programs; adolescent medicine physician specialists; a team of physicians, nurses, and social workers dedicated to patients with complex care needs; a lawyer; an occupational therapist; representatives from community epilepsy agencies; patients with epilepsy; parents of patients with epilepsy and severe intellectual disability; and project managers. Three main areas were addressed: (1) Diagnosis and Management of Seizures; 2) Mental Health and Psychosocial Needs; and 3) Financial, Community, and Legal Supports. Although there are no systematic studies on the outcomes of transition programs, the impressions of the TWG are as follows. Teenagers at risk of poor transition should be identified early. The care coordination between pediatric and adult neurologists and other specialists should begin before the actual transfer. The transition period is the ideal time to rethink the diagnosis and repeat diagnostic testing where indicated (particularly genetic testing, which now can uncover more etiologies than when patients were initially evaluated many years ago). Some screening tests should be repeated after the move to the adult system. The seven steps proposed herein may facilitate transition, thereby promoting uninterrupted and adequate care for youth with epilepsy leaving the pediatric system.
[Mh] Termos MeSH primário: Epilepsia/terapia
Transição para Assistência do Adulto/normas
[Mh] Termos MeSH secundário: Adolescente
Epilepsia/diagnóstico
Necessidades e Demandas de Serviços de Saúde
Seres Humanos
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE; PRACTICE GUIDELINE
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170920
[Lr] Data última revisão:
170920
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170707
[St] Status:MEDLINE
[do] DOI:10.1111/epi.13832


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[PMID]:28668449
[Au] Autor:Gabriel P; McManus M; Rogers K; White P
[Ad] Endereço:The National Alliance to Advance Adolescent Health, Washington, DC; Rutgers New Jersey Medical School, Newark, NJ.
[Ti] Título:Outcome Evidence for Structured Pediatric to Adult Health Care Transition Interventions: A Systematic Review.
[So] Source:J Pediatr;188:263-269.e15, 2017 Sep.
[Is] ISSN:1097-6833
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: To identify statistically significant positive outcomes in pediatric-to-adult transition studies using the triple aim framework of population health, consumer experience, and utilization and costs of care. STUDY DESIGN: Studies published between January 1995 and April 2016 were identified using the CINAHL, Ovid MEDLINE, PubMed, Scopus, and Web of Science databases. Included studies evaluated pre-evaluation and postevaluation data, intervention and comparison groups, and randomized clinic trials. The methodological strength of each study was assessed using the Effective Public Health Practice Project Quality Assessment Tool. RESULTS: Out of a total of 3844 articles, 43 met our inclusion criteria. Statistically significant positive outcomes were found in 28 studies, most often related to population health (20 studies), followed by consumer experience (8 studies), and service utilization (9 studies). Among studies with moderate to strong quality assessment ratings, the most common positive outcomes were adherence to care and utilization of ambulatory care in adult settings. CONCLUSIONS: Structured transition interventions often resulted in positive outcomes. Future evaluations should consider aligning with professional transition guidance; incorporating detailed intervention descriptions about transition planning, transfer, and integration into adult care; and measuring the triple aims of population health, experience, and costs of care.
[Mh] Termos MeSH primário: Avaliação de Processos e Resultados (Cuidados de Saúde)
Transição para Assistência do Adulto
[Mh] Termos MeSH secundário: Adolescente
Serviços de Saúde do Adolescente/organização & administração
Adulto
Pesquisa sobre Serviços de Saúde
Seres Humanos
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170911
[Lr] Data última revisão:
170911
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170703
[St] Status:MEDLINE


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[PMID]:28646002
[Au] Autor:Sawicki GS; Garvey KC; Toomey SL; Williams KA; Hargraves JL; James T; Raphael JL; Giardino AP; Schuster MA; Finkelstein JA
[Ad] Endereço:Divisions of General Pediatrics, gregory.sawicki@childrens.harvard.edu.
[Ti] Título:Preparation for Transition to Adult Care Among Medicaid-Insured Adolescents.
[So] Source:Pediatrics;140(1), 2017 Jul.
[Is] ISSN:1098-4275
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Parents of children with chronic illness consistently report suboptimal preparation for transition from pediatric- to adult-focused health care. Little data are available on transition preparation for low-income youth in particular. METHODS: We conducted a mailed survey of youth with chronic illness enrolled in 2 large Medicaid health plans to determine the quality of transition preparation using the Adolescent Assessment of Preparation for Transition (ADAPT). ADAPT is a new 26-item survey designed for 16- to 17-year-old youth to report on the quality of health care transition preparation they received from medical providers. ADAPT generates composite scores (possible range: 0%-100%) in 3 domains: counseling on transition self-management, counseling on prescription medication, and transfer planning. We examined differences in ADAPT scores based on clinical and demographic characteristics. RESULTS: Among 780 and 575 respondents enrolled in the 2 health plans, respectively, scores in all domains reflected deficiencies in transition preparation. The highest scores were observed in counseling on prescription medication (57% and 58% in the 2 plans, respectively), and lower scores were seen for counseling on transition self-management (36% and 30%, respectively) and transfer planning (5% and 4%, respectively). There were no significant differences in composite scores by health plan, sex, or type of chronic health condition. CONCLUSIONS: The ADAPT survey, a novel youth-reported patient experience measure, documented substantial gaps in the quality of transition preparation for adolescents with chronic health conditions in 2 diverse Medicaid populations.
[Mh] Termos MeSH primário: Doença Crônica/terapia
Qualidade da Assistência à Saúde/estatística & dados numéricos
Transição para Assistência do Adulto/estatística & dados numéricos
[Mh] Termos MeSH secundário: Adolescente
Adulto
Feminino
Pesquisas sobre Serviços de Saúde
Seres Humanos
Masculino
Medicaid
Pais
Estados Unidos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170907
[Lr] Data última revisão:
170907
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170625
[St] Status:MEDLINE


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[PMID]:28580608
[Au] Autor:Everitt IK; Gerardin JF; Rodriguez FH; Book WM
[Ad] Endereço:Emory University School of Medicine, Atlanta, Georgia, USA.
[Ti] Título:Improving the quality of transition and transfer of care in young adults with congenital heart disease.
[So] Source:Congenit Heart Dis;12(3):242-250, 2017 May.
[Is] ISSN:1747-0803
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:The transition and transfer from pediatric to adult care is becoming increasingly important as improvements in the diagnosis and management of congenital heart disease allow patients to live longer. Transition is a complex and continuous process that requires careful planning. Inadequate transition has adverse effects on patients, their families and healthcare delivery systems. Currently, significant gaps exist in patient care as adolescents transfer to adult care and there are little data to drive the informed management of transition and transfer of care in adolescent congenital heart disease patients. Appropriate congenital heart disease care has been shown to decrease mortality in the adult population. This paper reviews the transition and transfer of care processes and outlines current congenital heart disease specific guidelines in the United States and compares these recommendations to Canadian and European guidelines. It then reviews perceived and real barriers to successful transition and identifies predictors of success during transfer to adult congenital heart disease care. Lastly, it explores how disease-specific markers of outcomes and quality indicators are being utilized to guide transition and transfer of care in other chronic childhood illnesses, and identifies existing knowledge gaps and structural impediments to improving the management of transition and transfer among congenital heart disease patients.
[Mh] Termos MeSH primário: Cardiopatias Congênitas/terapia
Melhoria de Qualidade
Transição para Assistência do Adulto/normas
[Mh] Termos MeSH secundário: Adulto
Criança
Seres Humanos
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171102
[Lr] Data última revisão:
171102
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170606
[St] Status:MEDLINE
[do] DOI:10.1111/chd.12463


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Texto completo SciELO Chile
[PMID]:28548195
[Au] Autor:Bedregal P; Besoain C; Reinoso A; Zubarew T
[Ad] Endereço:Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile.
[Ti] Título:[Qualitative research methodology in health care].
[Ti] Título:La investigación cualitativa: un aporte para mejorar los servicios de salud..
[So] Source:Rev Med Chil;145(3):373-379, 2017 Mar.
[Is] ISSN:0717-6163
[Cp] País de publicação:Chile
[La] Idioma:spa
[Ab] Resumo:Health care research requires different methodological approaches such as qualitative and quantitative analyzes to understand the phenomena under study. Qualitative research is usually the least considered. Central elements of the qualitative method are that the object of study is constituted by perceptions, emotions and beliefs, non-random sampling by purpose, circular process of knowledge construction, and methodological rigor throughout the research process, from quality design to the consistency of results. The objective of this work is to contribute to the methodological knowledge about qualitative research in health services, based on the implementation of the study, “The transition process from pediatric to adult services: perspectives from adolescents with chronic diseases, caregivers and health professionals”. The information gathered through the qualitative methodology facilitated the understanding of critical points, barriers and facilitators of the transition process of adolescents with chronic diseases, considering the perspective of users and the health team. This study allowed the design of a transition services model from pediatric to adult health services based on the needs of adolescents with chronic diseases, their caregivers and the health team.
[Mh] Termos MeSH primário: Doença Crônica/terapia
Assistência à Saúde/métodos
Pesquisa Qualitativa
Transição para Assistência do Adulto
[Mh] Termos MeSH secundário: Adolescente
Serviços de Saúde do Adolescente
Feminino
Pessoal de Saúde
Seres Humanos
Masculino
Pais
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170808
[Lr] Data última revisão:
170808
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170527
[St] Status:MEDLINE


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[PMID]:28542322
[Au] Autor:Timmer A; Peplies J; Westphal M; Kaltz B; Ballauff A; Claßen M; Laass MW; Koletzko S
[Ad] Endereço:Division of Epidemiology and Biometry, Department of Health Services Research, Medical Faculty, Carl von Ossietzky University, Oldenburg, Germany.
[Ti] Título:Transition from pediatric to adult medical care - A survey in young persons with inflammatory bowel disease.
[So] Source:PLoS One;12(5):e0177757, 2017.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Transition to adult health services is a vulnerable phase in young persons with chronic disease. We describe how young persons with inflammatory bowel disease in Germany and Austria experience care during the transitional age, focusing on differences by type of provider (pediatric vs. adult specialist, no specialist). METHODS: This was a follow up survey in patients previously registered with a pediatric IBD registry. Patients aged 15 to 25 received a postal questionnaire, including a measure of health care experience and satisfaction. Descriptive analyses were stratified by age. Sub-analyses in the 18-20 year age group compared health care experience by type of provider. Determinants of early or late transfer were examined using multinomial logistic regression. RESULTS: 619 patients responded to the survey; 605 questionnaires were available for analysis. Usual age of completing transition was 18. Earlier transfer was more common with low parental SES (OR 1.8, 95% CI 0.7 to 4.6), and less common with advanced schooling (OR 0.5, 95% CI 0.2 to 1.2). Structured transition was uncommon. 48% of the respondents had not received any preceding transition advice. Overall satisfaction with IBD care was high, especially with respect to interpersonal aspects, but less so in aspects of continuity of care. CONCLUSIONS: Despite high overall patient satisfaction, relevant deficiencies in transitional care were documented. Some of these were associated with lower parental social status. Differences in health care satisfaction by type of provider (adult vs. pediatric) were small.
[Mh] Termos MeSH primário: Doenças Inflamatórias Intestinais
Inquéritos e Questionários
Transição para Assistência do Adulto
[Mh] Termos MeSH secundário: Adolescente
Adulto
Feminino
Pessoal de Saúde
Seres Humanos
Doenças Inflamatórias Intestinais/terapia
Masculino
Satisfação do Paciente
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170912
[Lr] Data última revisão:
170912
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170526
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0177757


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[PMID]:28534683
[Au] Autor:Jones MR; Robbins BW; Augustine M; Doyle J; Mack-Fogg J; Jones H; White PH
[Ti] Título:TRANSFER FROM PEDIATRIC TO ADULT ENDOCRINOLOGY.
[So] Source:Endocr Pract;23(7):822-830, 2017 Jul.
[Is] ISSN:1530-891X
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: Adult and pediatric endocrinologists share responsibility for the transition of youth with type 1 diabetes from pediatric to adult healthcare. This study aimed to increase successful transfers to adult care in subspecialty practices by establishing a systematic health care transition (HCT) process. METHODS: Providers from the adult and pediatric endocrinology divisions at the University of Rochester Medical Center met monthly to customize and integrate the Six Core Elements (6CEs) of HCT into clinical workflows. Young adult patients with type 1 diabetes having an outpatient visit during a 34-month pre-post intervention period were eligible (N = 371). Retrospective chart review was performed on patients receiving referrals to adult endocrinology (n = 75) to obtain (1) the proportion of patients explicitly tracked during transfer from the pediatric to adult endocrinology practice, (2) the providers' documentation of the use of the 6CEs, and (3) the patients' diabetes control and healthcare utilization during the transition period. RESULTS: The percent of eligible patients with type 1 diabetes who were explicitly tracked in their transfer more than doubled compared to baseline (11% vs. 27% of eligible patients; P<.01). Pediatric providers started to use transition readiness assessments and create medical summaries, and adult providers increased closed-loop communication with pediatric providers after a patient's first adult visit. Glycemic control and healthcare utilization remained stable. CONCLUSION: Successful implementation of the 6CEs into pediatric and adult subspecialty practices can result in improvements of planned transfers of pediatric patients with type 1 diabetes to adult subspecialty providers. ABBREVIATIONS: 6CEs = six core elements; AYA = adolescent and young adult; DKA = diabetic ketoacidosis; ED = emergency department; HbA1c = hemoglobin A1c; HCT = health care transition.
[Mh] Termos MeSH primário: Diabetes Mellitus Tipo 1/terapia
Endocrinologia/métodos
Transição para Assistência do Adulto
[Mh] Termos MeSH secundário: Adolescente
Adulto
Glicemia/metabolismo
Diabetes Mellitus Tipo 1/complicações
Diabetes Mellitus Tipo 1/metabolismo
Cetoacidose Diabética/epidemiologia
Cetoacidose Diabética/etiologia
Gerenciamento Clínico
Serviço Hospitalar de Emergência/utilização
Feminino
Hemoglobina A Glicada/metabolismo
Seres Humanos
Masculino
Estudos Retrospectivos
Fluxo de Trabalho
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Blood Glucose); 0 (Glycated Hemoglobin A)
[Em] Mês de entrada:1709
[Cu] Atualização por classe:171116
[Lr] Data última revisão:
171116
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170524
[St] Status:MEDLINE
[do] DOI:10.4158/EP171753.OR



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