The adolescent with chronic conditions

Question 1

How common are chronic conditions in adolescence?

Answer 1

14-18% of teenagers

Question 2

What is interdependence?

Answer 2

Recognising and distinguishing from each other situations in which one needs to rely on others and situations in which one needs to rely on oneself

Question 3

What makes separation and independence in kids with chronic conditions more difficult for parents?

What should we advise parents?

Answer 3

Need for treatment
Parental overprotection
Physical appearance - looking more youthful

To strike a balance between supervision and teen independence and self-care

Question 4

What are some factors that make it difficult for these teens to maintain friendships?

Answer 4

Hospitalisation
Appointments
Restrictions
Social isolation
Overprotective parents

Question 5

What are some of the challenges these teens have with school and work?

Answer 5

Absences from school (30%) and poor integration
Unrealistic expectations
Learning disabilities
Higher rates of unemployment (50-70% unemployment rate in ppl with disabilities compared with 5% in general population)
Difficulty with vocational planning
Limited economic support

Question 6

What are some physical differences that can affect youth with chronic conditions?

Answer 6

Delayed puberty - teach how to identify signs of puberty
Poor growth - bone age
Side effects of meds (ex steroids)

Question 7

Do kids with chronic conditions differ in their sexual development and experimentation?

Answer 7

Yes. Some studies show that teens with chronic conditions, especially visible chronic conditions, have higher rates of sexual activity and STIs. They also have higher rates of sexual abuse.
This all comes with lower rates of sexual education.

? trying to prove normalcy

Question 8

When teens with chronic conditions are sexually active, what do you need to consider as their physician?

Answer 8

What type of contraception is appropriate and is this affected by their condition
Accurate information about fertility (may be affected)
STI education (especially if perceived infertile)
Hereditary aspects of their disease
Affect of a possible pregnancy on condition and vice versa

Question 9

What are the goals of providing health care to youth with chronic conditions?

Answer 9

Optimal medical care
Adolescent involvement and independence (according to their development)
Adolescent and family education
Acknowledgement of personal potential for activity, education, recreation and functioning
Completion of adolescent developmental tasks
The attainment of self-esteem and self-confidence
The acknowledgement of personal potential for vocation or career.

Question 10

Why is educating a teenager with a chronic condition important?

Answer 10

Learn to avoid situations the exacerbate their condition
Learn to minimise the severity of exacerbations
Learn self-care skills to minimise daily effects of their illnesses

Question 11

What are the four different models of transition of care?

Answer 11

1. Disease focused - most common, at subspecialty clinics, often in MDTs
2. Transition coordination - Care is provided in a specific age range (18-25) and for a specific condition
3. Primary care
4. Adolescent focus - run by adolescent medicine specialists with a strong focus on the biopsychosocial model

Question 12

When should you transfer care to adult care? and when should you start talking about it?

Answer 12

The age of transfer needs to be flexible and consider developmental stage of the teenager
You should start talking about it at age 10-12

Question 13

What are the characteristics of a good transition?

Answer 13

Comprehensive
Continuous
Coordinated

Minimises disability and promotes access to health care and wellbeing