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 Researchers examined a critical juncture in adolescent medicine -
the transition from being a pediatric patient and getting a lot of
guidance from parents to becoming an adult who makes independent
medical decisions.
The study of 494 older adolescent and young adult patients found
that having chronic medical conditions was associated with greater
readiness for this transition, more self-involvement in completing
health-related tasks and less input from parents.
“On the one hand, it is encouraging that our sample of adolescents
and young adults with medical conditions were taking initiative to
self-manage their medical care given developmental expectations for
increased independence during emerging adulthood,” said lead study
author Cyd Eaton, a psychology researcher at the University of
Georgia in Athens.
“On the other hand, it remains unclear if assuming more autonomy for
completing these healthcare tasks translates into actual completion
of these tasks, independent of parental oversight,” Eaton said by
email.
Teens in the study were about 19 years old on average and 116 of
them had chronic medical conditions. The most common diagnosis was
asthma, which affected 73 of the youth, followed by hearing or
vision problems and neurological disorders.
Less common chronic health problems included diabetes, inflammatory
bowel disease, heart conditions, gastrointestinal disorders,
reproductive health issues, blood disorders, cancer, kidney or
urinary problems, and sickle cell disease, researchers report in the
Journal of Adolescent Health.
There was no meaningful difference between healthy and chronically
ill youth when it came to keeping appointments, talking with
providers or managing daily activities, the study found.
When participants had to live with illness, they did tend to be
better at tasks like managing medications and tracking health
issues. Overall, they were more prepared to transition to handling
their own medical care.
The study wasn’t a controlled experiment designed to prove how
chronic illness prepares teens to transition to being independent
adult patients, the authors note. Researchers also relied on
participants to report on their own abilities at certain tasks and
readiness to handle their own care, which might be biased. Most of
the participants were white and female, so their perspectives might
not reflect the experiences of all patients.
Even so, the findings highlight a need for parents and doctors to do
a better job of preparing healthy teens to become smart health
consumers, said Dr. Cora Collette Breuner, a pediatrics researcher
at Seattle Children’s Hospital and the University of Washington who
wasn’t involved in the study.
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At every visit, Breuner asks her young patients and their parents
what they want to get out of the visit and what they expect to
happen.
“If we providers ask this every time the patients will be more ready
to work with us to improve their health and stay more engaged in
both preventative health care and more meaningful health care
utilization,” Breuner said by email. “This study points out we need
to work on this.”
Teens may not be able to legally consent to treatment or sign
medical documents, but parents can still start gradually giving them
more responsibilities, said Dr. David Stukus, an allergy and
immunology researcher at Nationwide Children’s Hospital in Columbus,
Ohio, who wasn’t involved in the study.
“Preparing teenagers for independent living and managing their own
health doesn’t happen overnight - this takes years of preparation
and practice,” Stukus said by email. “Parents should start this
process early.”
Parents should expect teens to be more involved in their own care,
including having children schedule their own appointments, prepare a
list of questions for doctors, and handling their own check-in and
check-out, said Sarah Clark, a children’s health researcher at the
University of Michigan in Ann Arbor who wasn’t involved in the
study.
“And parents, stay out of the exam room,” Clark said by email.
“Allow teens and providers to have a focused and private
conversation.”
SOURCE: http://bit.ly/2mtdvrj Journal of Adolescent Health, online
March 5, 2017.
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