Assessing the psychosocial health of adolescents with chronic diseases

Chronic diseases affect up to 15% of adolescents, and their prevalence continues to rise. As adolescence and chronic diseases interact in complex and evolving ways, ensuring comprehensive care and facilitating a successful transition to adult services are major challenges for pediatric services. It is essential to take psychosocial aspects into account to promote autonomy and continuity of care during this vulnerable period.

To assess how psychosocial dimensions are evaluated and documented among adolescents with chronic illnesses in specialized pediatric services, and to explore healthcare professionals' views on barriers to addressing sensitive issues.

We conducted a retrospective analysis of paper and electronic medical records of adolescents transferred to adult care between December 2015 and February 2021 from two pediatric units (Gastroenterology and Urological & Digestive Surgery). Psychosocial data were extracted using a form. In parallel, 27 healthcare professionals (16 physicians, 11 nurses) completed a self-administered questionnaire about their practices and the perceived obstacles to discussing psychosocial issues.

Forty-six patient records were analyzed (35% female). The median follow-up time was 19 years [IQR 10-20] in Surgery and 7 years [IQR 5-12] in Gastroenterology, with a total of 16 diagnoses. Home (96%), education (93%), and activities (87%) were the most frequently recorded domains, while substance use (26%), sexuality (30%), and mental health (32%) were rarely noted. Sexuality was documented significantly more often in girls than boys (75% vs 7%, p < 0.001). Reported barriers included lack of time (62%), privacy concerns (56%), and the assumption that another professional would address the issue (44%).

Although psychosocial assessment is recognized as essential, it remains irregularly performed and documented. Implementing validated and structured tools could help standardize practice, improve multidisciplinary communication, and ultimately facilitate the transition of adolescent to adult care.