| Learning Objective #1: Define the term "transitioning" and its implications for adolescents with special health care needs | |||
| Learning Objective #2: Identify key educational elements to incorporate into adolescent transitioning protocols |
Ninety-six former patients were identified from the medical records at a 30-bed pediatric specialty hospital. Forty-six (47.9%) were contacted by telephone. Ages ranged from twenty-two to forty years with a mean of 29.8 years.
The survey addressed frequency of health care visits with a primary care provider, neurosurgeon, neurologist, orthopedic surgeon, and urologist. Reasons for visits, participation in a multidisciplinary clinic for adults, surgical procedures since twenty-one years of age, and a satisfaction with quality of care were also obtained. A Chi-square analysis using a Fisher's Exact test was used to analyze the frequency of visits in patients in multidisciplinary clinics vs. non-coordinated care.
Nine patients (19.6%) received care in an adult multidisciplinary clinic. The remaining 37 had no coordinated care. The frequency of annual routine visits to a primary care provider, neurosurgeon, orthopedic surgeon, and neurologist in multidisciplinary clinic patients were significantly higher (p=<.05) than non-coordinated care patients. There were also differences noted in frequency of surgical interventions and reasons for these interventions between the multidisciplinary clinic patients and non-coordinated care patients. Satisfaction ratings for care provided showed 77.8% of clinic patients were satisfied, while 21.6 % of non-coordinated care patients were satisfied.
Facilitating links to adult multidisciplinary care is important, however, these types of settings are not universally available for adults with special health care needs. Nurses play a pivotal role in incorporating self-advocacy training, health care education and accessing appropriate health care as part of transition protocols.