Chronic conditions and screening

Question 1

What is a chronic condition?

Answer 1

= refers to a condition that interferes with daily functioning for more than 3 months in a year, causes hospitalisation of more than 1 month in the year and or is likely to do either of these

Question 2

What are common chronic conditions in childhood?

Answer 2

• Asthma (most common)
  
  • Type 1 diabetes (IDDM)
    
    • maintenance of glycemic control is crucial in reducing long term complications
  • childhood cancers

Question 3

What are three conditions at birth?

Answer 3

1. Congenital birth defects
2. Chromosomal birth defects
3. Genetic defects

Question 4

What is congenital birth defects

Answer 4

= health problem or physical abnormalities that are present at birth and may result in long-term disability, morbidity or death

	- e.g. Hypospadias, neural tube defects, cleft lip and palate, cardiovascular defects, intestinal tract defects 
	- Midline defect —> defects originating either in the midline or in bilateral and symmetric structures e.g. heart & facial

Question 5

What are chromosomal birth defects?

Answer 5

= birth defect caused by an alteration in number or structure of chromosomes

	- Trisomy 21 (down’s syndrome) 
	- Trisomy 13 (pat syndrome) 
	- Trisomy 18 (Edwards syndrome)

Question 6

What are genetic birth defects?

Answer 6

= mutations or alterations to chromosomes caused by abnormal genome

- common single gene defects in children include 
	e. g, cystic fibrosis, PKU, sickle-cell anaemia, Thalassaemia

Question 7

What are three types of childhood disability?

Answer 7

1. Complex motor disability = child whose primary problem is significant disorder of movement, which is often complicated by
   other associated impairments such as defects
2. Cerebral palsy
   = umbrella term of non-progressive but often changing motor impairment syndromes
3. Muscular dystrophy
   = MD broad term that describes genetic (inherited) disorder of the muscles, causing the muscles to become very weak

Question 8

Impact of chronic illness/ disability on family

Answer 8

• uncertainty of future, emotional grieving
• social isolation
• missed days from work
• financial losses
• physical and emotional challenges
• more likely to suffer from depression
• higher rates of divorce

Question 9

Impact of chronic illness on adolescent development

Answer 9

Physical
• Short stature and delayed puberty
• Weight management
• Visible signs of illness and treatment

Cognitive
• Illness or disability itself may affect cognition
• Learning difficulties due to school absenteeism

Psychosocial	
•	Increased physical and emotional 
       dependence on family/carer
•	Stigma and exclusion 
•	Social isolation 
•	Poorer emotional wellbeing 
•	Lack of social, educational, and vocational opportunities 
•	Increase in risk taking behaviour 
•	Higher rates of D and A and sexual activity

Family
•Time, financial and physical burden on family/carers
• Parental frustration, anxiety, anger and depression, sibling issues

Question 10

What is transition to adult health care?

Answer 10

= the purposeful, planned movement of adolescents and young adults with chronic physical and medical conditions from child-centred to adult orientated health are system

Question 11

What are the challenges for adolescents and parents during transition to adult health care?

Answer 11

Parents
- - abandonment, feel of being perceived as difficult, anxiety and stress, fears of falling through the cracks

Adolescents
- different models of care and culture, late in commencing prep for transition , interoperation of transition as rejection

Question 12

What are the principles of care in transition?

Answer 12

1. A systematic and formal transition process
2. Early preparation
3. Identification of a transition coordinator
4. Good communication
5. Individual transition plan
6. Empower, engage and enable youth to self manage
7. Follow up and evaluate