Making Transitioning a Process
Developmental, Transitioning, and Adolescent Models of Care
| Pediatric Model | Adult Model | ||||||||
| Family Centered | Patient Centered | ||||||||
| Health Maintenance | Disease Management | ||||||||
| Developmental Focus | Progressive Decline Focus | ||||||||
| Prescriptive (responsible for) | Collaborative (responsible to) | ||||||||
| Source: Patricia White | |||||||||
| Disease Specific | Generic | Primary Care | Single Site |
| Patient transitions from a pediatric specialist to a pediatric/adult specialist to an adult provider | Patient moves from pediatrics (birth-14) to an adolescent program (15-24) to an adult program (>24 years) | The family general practitioner is the patient's care coordinator, and specialist(s) serves as consultant | Patient moves from pediatric care to adolescent care to adult care within the same environment, where clinical services remain constant |
As bridges between pediatric and adult models of care, adolescent programs strive to:
- Shift health care responsibility from the parent and provider to the youth
- Promote growth, self-expression, and personal decision-making
- Provide planned, purposeful transition interventions
- Move clients with chronic illnesses from child-centered to adult-centered health care systems
Adolescents are members of their families as well as their peer systems; they are also vital participants within the health care, community, and education systems. Negotiating these systems requires skills that may become impaired as a result of the effects of stress, illness, and other psychosocial factors factors such as parental lack of familiarity with the health care system due to recent migration or linguistic sensitivity from clinicians. Success or failure in transitioning to adult health care when youth approach age 21 or 24 hinges on mastering or failing to master central life skills. These life skills include the ability to access and negotiate medical and case management systems, develop a knowledge of self-care, and acquire the resources for pursuing additional education.
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