THE ROLE OF TRANSITION CLINIC IN THE HEALTH CARE OF ADOLESCENTS WITH CHRONIC INFLAMMATORY BOWEL DISEASE
Autori:
Tena Trbojević, Iva Hojsak, Lana Ivković, Sanja Kolaček
Sažetak
Upalne bolesti crijeva jesu kronične bolesti probavnog sustava koje se u trećine bolesnika klinički očituju u prvih 18 godina života. Stjecanjem punoljetnosti pedijatrijski bolesnici prelaze u zdravstvenu skrb odraslih, koja od njih zahtijeva samostalnost i odgovornost. Adolescenti s kroničnim bolestima često nisu spremni samostalno se brinuti za svoje zdravlje. Radi osiguranja kontinuiteta zdravstvene skrbi i premošćivanja dostupnosti specijalističko-konzilijarne skrbi u odrasloj dobi nametnula se potreba za jasno strukturiranim i organiziranim prijelazom koji se naziva tranzicijskom skrbi, gdje nadzor nad bolesnikom istodobno provode liječnici pedijatrijske i internističke struke radi osposobljavanja oboljelih adolescenata za samostalno preuzimanje kontrole, bez nadzora i pomoći roditelja. Takva je skrb organizirana u mnogim razvijenim zemljama za različite kronične bolesti, a ne samo za upalne bolesti crijeva. Namjena je ovoga preglednog članka prikazati dosadašnja iskustva u organizaciji tranzicijske skrbi u razvijenim zemljama Europe te obrazložiti na koji način i zašto se to namjerava učiniti i u Zagrebu.
Summary
Inflammatory bowel disease (IBD) is a chronic disease of the digestive system that occurs in one third of cases in childhood and adolescence. In the majority of patients IBD persists and relapses more or less frequently during their whole life and therefore pediatric patients, at some point, are transferred to the adult health care where autonomy and responsibility are required. However, adolescents with inflammatory bowel disease are mostly insufficiently competent in respect to disease specific knowledge and self-management skills what can lead to poor disease outcome. Therefore, to enable adolescent patients continuing healthcare and bridging the gap between pediatric and adult services, gain independence and manage disease without parental assistance, structured and organized transition (transitional care) is required, whereby for a defined period of time health care is provided by both pediatricians and internal medicine specialists. That kind of care is carried out in many developed countries through transition clinics which have been organized for patients with a wide spectrum of chronic diseases, IBD included. The aim of this review is to investigate current organizational aspects of the transition care for adolescents with chronic diseases, namely IBD, and to present the published experience in the developed European countries. The final goal is to justify organization of the transition care for IBD patients in Zagreb and to provide methods of the implementation of this kind of care in Zagreb.
