CHRONIC DISEASE AND HEALTH CONDITION PREVENTION IN CHILDHOOD – 2nd part: EMPHASES FROM THE 14th SYMPOSIUM OF PREVENTIVE PEDIATRICS
Autori:
Maja Batinica, Josip Grgurić, Filip Jadrijević-Cvrlje
Sažetak
Kronično bolesne djece danas je u razvijenim društvima sve više, a zbog modernih terapijskih mogućnosti sve više djece preživljava do odrasle dobi. Duži životni vijek ne znači nužno i bolju kakvoću života. S kronično bolesnim djetetom važan je holistički pristup koji uključuje ne samo ostvarivanje najviših mogućih standarda u dijagnostici i liječenju već i posebnu brigu za prevenciju bolesti. Sve je to važno u tzv. integrativnom pristupu u pomoći djetetu s kroničnim poremećajem, s ciljem postizanja što bolje kakvoće života i što potpunije socijalne integracije. Na XIV. simpoziju preventivne pedijatrije, održanom u Skradu 1. lipnja 2013., razmatrani su, s preventivnoga gledišta, ovi kronični poremećaji u dječjoj dobi: poremećaj pozornosti s hiperaktivnošću, migrenozne glavobolje, bolesti štitnjače, leukemije, cistična fibroza, kronična bubrežna bolest, kronične upalne bolesti jetre, kronične upalne bolesti crijeva, juvenilni idiopatski artritis te kronični sekretorni otitis. Naglašeno je da kada se govori o prevenciji, prilikom razmatranja određene bolesti na umu treba imati tri oblika prevencije – primarnu, sekundarnu i tercijarnu, a to znači: kako smanjiti pojavnost bolesti, kako je rano otkriti i ispravno liječiti te naposljetku kako poboljšati kakvoću života djeteta s kroničnom bolesti. Kvartarna prevencija, s ciljem smanjenja polipragmazije, uključuje mjere za ublažavanje ili izbjegavanje rezultata nepotrebnih ili suvišnih intervencija zdravstvenog sustava. Važan je proces i prijenos skrbi o pacijentu iz dječje dobi u odraslu dob. U odrasloj dobi važan je nastavak praćenja i nadzor kroničnog stanja, zbog mogućeg razvoja kasnih posljedica kronične bolesti u djetinjstvu.
Summary
Chronically ill children nowdays in developed countries are more prevalent than before, and thanks to modern therapeutic modalities more children are surviving into adulthood. Increased survival cannot be assumed to be associated with increased quality of life. With the chronically ill child holistic approach is important, which incorporates not only realisation of the highest possible standards in diagnostics and treatment, but also special care for disease prevention. All this is very important in so called integrative approach in the care of a chronically ill child, with the aim of achieving as high as possible quality of life and complete social integration. At the 14th Preventive Pediatrics Symposium, which took place in Skrad, June 1st 2013, from preventive standpoint, the following chronic childhood illnesses were discussed: attention deficit hyperactivity disorder – ADHD, migraine, thyroid gland diseases, leukemia, cystic fibrosis, chronic renal disease, chronic inflammatory liver disease, chronic inflammatory bowel disease, juvenile idiopathic arthritis, and chronic otitis media with effusion. It is emphasized that talking about a disease prevention, there are three levels of it – primary, secondary and tertiary prevention: how to avoid occurrence of disease, how to diagnose and treat existent disease in early stages, before it causes significant morbidity, and finally how to reduce the negative impact of existent disease by restoring function and reducing disease-related complications – how to improve quality of life of children with chronic diseases. Quaternary prevention describes methods to mitigate or avoid results of unnecessary or excessive interventions of the health system. An important process is also transition of care from child-oriented to adult-oriented care. Adults with chronic health conditions should continue to be evaluated periodically for possible late consequences of their childhood illness and previous medical treatments.
