Fernando García-Rodríguez1, Ana C Arana-Guajardo2, Ana V Villarreal-Treviño1, Roberto Negrete-López3, José A López-Rangel4, Brenda J Fortuna-Reyna1, María E Corral-Trujillo3, Sol Jiménez-Hernández1, Patricia R Áncer-Rodríguez5, Mayra G Herrera-López5, Óscar Salas-Fraire6, Karina Salas-Longoria6, Manuel E de la O-Cavazos1, Dionicio Á Galarza-Delgado3, Nadina Rubio-Pérez7. 1. Department of Pediatrics, Universidad Autónoma de Nuevo León. Madero Y Gonzalitos S/N, Col. Mitras Centro 64460, Monterrey, Nuevo León, Mexico. 2. Servicio de Reumatología, Instituto de Medicina Interna. Escuela Nacional de Medicina Sistema Tec Salud, Monterrey, Mexico. 3. Rheumatology Service, Universidad Autónoma de Nuevo León. Madero Y Gonzalitos S/N, Col. Mitras Centro, Monterrey, Nuevo León, Mexico. 4. Department of Psychiatry, Universidad Autónoma de Nuevo León. Madero Y Gonzalitos S/N, Col. Mitras Centro, Monterrey, Nuevo León, Mexico. 5. Department of Nutrition at Hospital Universitario "Dr. José E. González", Universidad Autónoma de Nuevo León.Madero Y Gonzalitos S/N, Col. Mitras Centro, Monterrey, Nuevo León, Mexico. 6. Department of Rehabilitation and Sports Medicine, Universidad Autónoma de Nuevo León.Madero Y Gonzalitos S/N, Col. Mitras Centro, Monterrey, Nuevo León, Mexico. 7. Department of Pediatrics, Universidad Autónoma de Nuevo León. Madero Y Gonzalitos S/N, Col. Mitras Centro 64460, Monterrey, Nuevo León, Mexico. nadinaangel@hotmail.com.
Abstract
OBJECTIVES: To describe the design process of a medical care program for adolescents with pediatric onset rheumatic diseases (PRD) during the transition from pediatric to adult care in a resource-constrained hospital. METHODS: The model of attention was developed in three steps: 1) the selection of a multidisciplinary team, 2) the evaluation of the state of readiness of patients and caregivers for the transition, and 3) the design of a strategy of attention according to local needs. The results of the first two steps were used in order to develop the strategy of attention. RESULTS: The transition process was structured in three stages: pretransition (at pediatric rheumatology clinic), Transition Clinic for Adolescents with Rheumatic Diseases (TCARD, the main intervention), and post-transition (at adult rheumatology clinic). Each stage was divided, in turn, into a variable number of phases (8 in total), which included activities and goals that patients and caregivers were to accomplish during the process. A multidisciplinary approach was planned by pediatric and adult rheumatologists, nutritionists, physiatrists, psychiatrist, psychologist, nurse, and social worker. During TCARD, counseling, education, nutritional, physical, and mental health interventions were considered. CONCLUSIONS: The proposed transition model for patients with rheumatic diseases can be a useful tool in developing countries.
OBJECTIVES: To describe the design process of a medical care program for adolescents with pediatric onset rheumatic diseases (PRD) during the transition from pediatric to adult care in a resource-constrained hospital. METHODS: The model of attention was developed in three steps: 1) the selection of a multidisciplinary team, 2) the evaluation of the state of readiness of patients and caregivers for the transition, and 3) the design of a strategy of attention according to local needs. The results of the first two steps were used in order to develop the strategy of attention. RESULTS: The transition process was structured in three stages: pretransition (at pediatric rheumatology clinic), Transition Clinic for Adolescents with Rheumatic Diseases (TCARD, the main intervention), and post-transition (at adult rheumatology clinic). Each stage was divided, in turn, into a variable number of phases (8 in total), which included activities and goals that patients and caregivers were to accomplish during the process. A multidisciplinary approach was planned by pediatric and adult rheumatologists, nutritionists, physiatrists, psychiatrist, psychologist, nurse, and social worker. During TCARD, counseling, education, nutritional, physical, and mental health interventions were considered. CONCLUSIONS: The proposed transition model for patients with rheumatic diseases can be a useful tool in developing countries.