1 / 26

Transition to adolescence and beyond

Transition to adolescence and beyond. Dan Wood Consultant in Adolescent and Reconstructive Urology University College London Hospitals Honorary Consultant Urologist Great Ormond Street. Objectives. Some definitions What does transition mean? ‘ C’ing the issues Other issues.

gayle
Download Presentation

Transition to adolescence and beyond

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Transitionto adolescence and beyond Dan Wood Consultant in Adolescent and Reconstructive Urology University College London Hospitals Honorary Consultant Urologist Great Ormond Street

  2. Objectives • Some definitions • What does transition mean? • ‘C’ing the issues • Other issues DW UCLH

  3. Adolescence • Latin • Adolescere • (to) grow • Presents Challenges DW UCLH

  4. “An increasing number of chronically ill children are surviving into young adulthood. Achieving a seamless transfer is becoming one of the greatest challenges facing both children's and adult services.” Fiona Smith Adviser in Children's and Young People's Nursing Royal College of Nursing DW UCLH

  5. DW UCLH

  6. What do we think? Friday November 7th2008 Tranisition clinic - GOSH DW UCLH

  7. Challenges consultation Change DW UCLH

  8. Consultation • Different environment • New personnel • Information loss • Different medical approach • Potential for conflicting messages DW UCLH

  9. Consultation • Building for the rest of your life • Regular checks • Baseline • New team members • Watch for problems • ?Need for travel??? DW UCLH

  10. Challenges consultation confidentiality Change DW UCLH

  11. Confidentiality • Parents in vs. parents out • New issues • Embarrassment • We have to look to build a trust • They will grow up DW UCLH

  12. Challenges consultation confidentiality Change consent DW UCLH

  13. Consent • No consent is just me • All complex decisions need time • …and discussion • Important role of our CNS • Choices – this can be difficult DW UCLH

  14. Consent • For straight forward procedures – usually no problem • Able to sign for themselves • May raise issue from the past • Should be a process not an event DW UCLH

  15. Challenges consultation confidentiality consent concordance Change DW UCLH

  16. Concordance • With freedom comes responsibility • Some have difficulty with this • Unsafe? • Difficult • Usually finite DW UCLH

  17. Challenges consultation confidentiality Change concordance consent conjugation DW UCLH

  18. Conjugation • Permission • Ability • Fertility • Concerns DW UCLH

  19. Challenges consultation confidentiality Change consent concordance conjugation conflict DW UCLH

  20. Conflict • With me • With you • With others • With themselves DW UCLH

  21. Conflict • Listen • Understand • Explain • Give time • Re-Explain • Empower DW UCLH

  22. Other concerns • Future surgery • Continence • Other diseases • Children (1/70 – 1/100) • Historical comparison DW UCLH

  23. Obstetrics • Several studies – 45 ladies 49 deliveries • May need Caesarian section • All likely to need shared care • Prolapse is a problem but treatable DW UCLH

  24. The long-term • Regular reviews • Good communication with GPs • Follow-up bloods • Scans • Expertise • Outcomes - ?database DW UCLH

  25. Summary • Some definitions • What does transition mean? • ‘C’ing the issues • Other issues DW UCLH

  26. Thank you Any Questions? DW UCLH

More Related