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Transition Programs in Pediatric Diabetes: Steps Towards Healing & True Self-Management

Explore the challenges and resources needed for successful transitions from childhood to adolescence and adulthood in pediatric diabetes care. Learn about optimal metabolic control, integration of diabetes into daily life, and parental support.

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Transition Programs in Pediatric Diabetes: Steps Towards Healing & True Self-Management

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  1. Transition Programs in Pediatric Diabetes: One Step in the Journey of Healing & True Self-Management

  2. Transition means: .

  3. If you were an adolescent ready to move on to an adult diabetes clinic, you would want to have: • ______________________________ • ______________________________ • ______________________________

  4. If you were a parent of an adolescent moving on to an adult clinic you want to be assured about and have: • ____________________________ • ____________________________ • ____________________________

  5. Transitions: Exist in Context – Successful transitions mean comprehensive, long term preparation! In diabetes, usually addressed at HS Graduation: • Challenges: • optimal metabolic control • normal growth & development • integration of diabetes into daily life • parental stress • Challenges: • dependence vs. independence • responsible management behavior • less than optimal metabolic control • risk taking intensity • Challenges: • burnout, despair, depression • integration into work & family life • achieving & maintaining optimal metabolic control Childhood Adolescence Adulthood • Needed Resources: • optimal self management education • individual & family counseling • health care team support 24/7 • Needed Resources: • relevant, effective messaging to adolescent & family • family counseling & support • peer support • Needed Resources: • individual & family counseling & support • Access to comprehensive care • self-management long term care strategy Transition: Adolescence > Adulthood

  6. Transitions: Exist in Context – Successful transitions mean comprehensive, long term preparation! In diabetes, usually addressed at HS Graduation: • Challenges: • optimal metabolic control • normal growth & development • integration of diabetes into daily life • parental stress • Challenges: • dependence vs. independence • responsible management behavior • less than optimal metabolic control • risk taking intensity • Challenges: • burnout, despair, depression • integration into work & family life • achieving & maintaining optimal metabolic control Childhood Adolescence Adulthood • Needed Resources: • optimal self management education • individual & family counseling • health care team support 24/7 • Needed Resources: • relevant, effective messaging to adolescent & family • family counseling & support • peer support • Needed Resources: • individual & family counseling & support • Access to comprehensive care • self-management long term care strategy Transition: Adolescence > Adulthood

  7. >>Must happen before launching:Assessment For Family Functioning:While in Pediatrics in order to move to >>> Adults> • Family emotional supportiveness • Between parents -- are mother and father emotionally available to each other? • Availability -- is there flexibility with daily schedules? • Family organization • Joint decision making -- between spouses • Value congruence -- between spouses • Communications patterns -- are messages about rules clear or confusing? • Competence/effectiveness • Response to initial symptoms Baker, Rosman, Nogueira, Sargent; Unpublished research data, 1979

  8. Transition Clinics: A Bridge from where they’ve been to where they’re going: Challenges: • Providing effective continuum of care • Adequate preparation for “launching” & associated anxiety related to separation • Having to tell my whole story again/being an “unknown” • No “chemistry”/No show! – Lost Children/Lost Adults • Preparing for leaving home/being on one’s own

  9. Transition Clinics: A Bridge from where they’ve been to where they’re going:( cont.) • at least 6 month ramp up preparation for transition – from both clinics • effective patient & family needs assessment to help facilitate leaving home/doing daily diabetes management more independently • Identification of on-going support personnel and resources/role clarification

  10. Transition Clinics: A Bridge from where they’ve been to where they’re going: Resources Needed: • individual & family counseling – impact of past management behavior on reality of future plans • launching & landing support – collaborative clinical support from both peds and adult clinics working together • adult clinicians at peds clinic & peds clinicians at adult clinic

  11. educate enrich advocate emphasize

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