Transition from pediatric to adult medical attention inn renal transplantation

Abstract

Transition from pediatric care to adult care in patients with chronic diseases presents aspects to take into account when reconsidering the passage as an actuation protocol. The objective of the studywas to explore the derivation characteristics and satisfaction with the professional care experienced by renal transplant patients in the transition process from pediatric care to adult care. We included 20 follow-up patients in the Nephrology and Transplant Unit of the Hopital Argerich patients who had been transplanted in pediatric centers institutions. We performed a semi-structured interview assessing satisfaction with professional care and educational level and work situations areas. The average age at the time ot the interview was 27 years old and average transition age was 20-38 years old, sex distribution was 13 males 7 females. In education and work fields we found that 11 patients worked, being only 4 of them under a labor relationship. During dialisis period 5 patients abandoned their sudies. The group that dropped out school currrently is not working or have a precarious or uncertain labor situation. No patient had contact prior to transition with the adult group, but the 8 would have liked to have a previous contact. No patient knew about the transition 6 months before it took place and 15 patients said that they hadn’t been prepared for it. Of the 20 patients interviewd 19 said that treatment received in the hospital was good to very good 10 patients had difficulties in adapting to the new situation while 11 experienced negative feelings to the change. 14 patients said that they felt more responsible with respect to their illness care. In 13 patients the family does not participate in the actual treatment and when asked if they would like everbody to participate all of them answered negatively. During adult service follow-up 11 patients needed hospitalization and when asked how they felt during the same 7 considered it regular or bad. We con clude that programmed referral is a pending issue of both medical groups It should be included into an institutional policy under a formal referral and a follow-up program with the necessary tools to evaluate and predict adherence.