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Physicians as barriers to successful transitional care
1Institute of Child Health, London, United Kingdom. adam.fox2@virgin.net
Insights
The transition of chronically ill children to adult care presents challenges due to planning gaps and physician attitudes. Enhancing adolescent services and inter-service links can improve this critical care handover process.
Area of Science:
- Pediatric Healthcare
- Transition Medicine
Background:
- Rising survival rates of chronic childhood diseases into adulthood necessitate improved care transitions.
- Effective transfer from pediatric to adult medical services is a significant challenge.
Purpose of the Study:
- To identify barriers to successful transition from pediatric to adult medical care.
- To explore factors influencing physician attitudes and patient independence during care transfer.
Main Methods:
- The study analyzes existing literature and clinical observations regarding the transition process.
- Identifies barriers stemming from patients, families, logistics, and healthcare providers.
Main Results:
- Barriers include lack of integrated planning, physician confidence issues, and emotional/financial factors.
- Paediatricians may resist transition due to lack of confidence in adult colleagues.
- Poor disease understanding by pediatric-trained doctors highlights the need for transfer.
Conclusions:
- Developing specialized adolescent services and fostering closer links between pediatric and adult care are crucial.
- Promoting patient independence through a culture of personal health responsibility is essential.
- Addressing physician and systemic barriers can enhance the transition experience for emerging adults.
Abstract:
There has been a dramatic increase in the number of sufferers of chronic childhood diseases surviving into adulthood. Effective transition of these children from paediatric to adult medical services is a considerable challenge. A lack of integrated planning for this event can present barriers to successful transition. These barriers may be generated by the patient, his family or by political or logistical factors. However, physicians themselves can also become barriers in this process. Paediatricians may resist the transition process as they lack confidence in their adult colleagues. Emotional, academic, financial and cultural issues will also influence both child and adult physician's attitude to the hand-over of care. Increasingly poor understanding of their disease process by Paediatric trained doctors, makes transfer of care essential for adolescents. The move towards a culture of personal responsibility for health care is also crucial for the promotion of the maturing patient's independence. Development of adolescent services and closer links between the services could do much to enhance the transition experience of emerging adults.
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