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DOI: 10.1055/s-0037-1617798
Barrieren beim Transfer von Jugendlichen mit Diabetes mellitus Typ 1 in die Erwachsenenmedizin
Barriers of transfer of adolescents with diabetes mellitus type 1 into adulthoodPublication History
Publication Date:
10 January 2018 (online)
Zusammenfassung
Derzeit existieren in Deutschland keine Modelle, die einen systematischen Transfer von Jugendlichen mit Diabetes mellitus Typ 1 von der pädiatrischen Betreuung in die Erwachsenenmedizin gewährleisten. Diese Übersicht soll Barrieren beim Übergang von Adoleszenten mit Diabetes mellitus Typ 1 von der pädiatrischen zur internistischen Bertreuung identifizieren. Die Hindernisse werden aus der Sicht der daran beteiligten Parteien geschildert: der Jugendliche, die Familie, das pädiatrische und das internistische Team. Die Barrieren des Transfers von Seiten des Adoleszenten/jungen Erwachsenen sind soziale Veränderungen, wie Unabhängigkeitbestrebungen und Auszug aus dem Elternhaus, Berufswahl, Partnerschaft; psychische und endokrinologische Faktoren. Der Transfer sollte in der pädiatrischen Sprechstunde so früh wie möglich vorbereitet werden. Der Zeitpunkt des Ärztewechsels sollte in Abhängigkeit von der physischen und psychischen Reife, dem Gesundheitsstatus und dem Lebensabschnitt zwischen dem 16. und 20. Lebensjahr erfolgen. Voraussetzungen sind 2 multidisziplinäre Teams, ein pädiatrisches und ein internistisches, mit gemeinsamer Behandlungsphilosophie, regelmäßiger Kooperation und Qualitätskontrolle. Der Patient soll in den Übergangsprozess aktiv einbezogen werden. Wünschenswert sind eine gemeinsame Sprechstunde mit dem Pädiater und dem weiter betreuenden Arzt und die Vorstellung des neuen Diabetesteams.
Summary
In Germany there is a lack of models for a systematic transfer of adolescents with diabetes mellitus type 1 from paediatric to adult health care services. This review identifies barriers of transition of adolescents with diabetes mellitus type 1 from paediatric to adult health care providers. The underlying barriers have to be seen from the view of the adolescents, his or her family, the paediatric and the following caregiver for adults. Barriers for the adolescent/the young adult are social changes such as independence, leaving the parental home, vocation or partnership; psychological and endocrine factors such as insulin resistance. The transfer should be planned systematically as early as possible. The timing of changing the health care providers has to be seen in dependence of physical and mental maturity, the health status and should occur between the age of 16 and 20 years. Requirements are 2 multiprofessional teams, a paediatric and an internal team, both with an idendical treatment philosophy, regular cooperation and quality management. Desirable is a joint consulting hour with the paediatrician and the internal specialist and the introduction of the new team.
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