A discussion of healthcare support for adolescents and young adults with long‐term conditions: Current policy and practice and future opportunities. Issue 5 (18th August 2020)

• Record Type: Journal Article
• Authors: James, Steven; Perry, Lin; Gallagher, Robyn; Lowe, Julia
• Is Part Of: International journal of nursing practice. Volume 26:Issue 5(2020)
• Page Start: n/a
• Page End: n/a
• Publication Date: 2020-08-18
• Subjects: adolescents -- diabetes mellitus, type 1 -- health services -- nurses -- young adults; Nursing -- Periodicals; Nursing -- Practice -- Periodicals; 610.73092
• DOI: 10.1111/ijn.12882
• Languages: English
• ISSNs: 1322-7114

Abstract

Abstract: Background: Adolescence and young adulthood can be a period of significant and unique life changes in which competing demands and challenges distract from disease self‐management. Specific challenges related to the way individual services are configured can also limit the support available. This paper presents a discussion of healthcare service support for adolescents and young adults, using type 1 diabetes as an exemplar. Design: Discussion paper. Results: A wide variety of issues at the biopsychosocial level of the individual, health services policy and practice pose challenges to effective health support for adolescents and young adults. Intersectoral, multilevel and multicomponent opportunities are available to engage and empower young people to be part of change and accountability mechanisms and to transform the support available and outcomes achievable. A priority research agenda can benefit patients, families and their communities. Conclusion: Future policy and practice development may assist clinicians, service providers and managers, policymakers, non‐governmental organizations and community groups to deliver more effective and efficient support to vulnerable adolescent and young adult populations. SUMMARY STATEMENT: What is already known about the topic? Multiple issues affecting adolescents and young adults can deter self‐management and contribute to deterioration in health in young adults. In young people with chronic conditions such as type 1 diabetes, this can accelerate onset of disease complications and co‐morbidities. Current service models often fail to acknowledge or address the unique needs of this population. What this paper adds? Adolescents and young adults need age‐specific services codesigned to engage and empower, staffed with clinicians with expertise in relevant communication as well as clinical skills. New technologies should be adopted to address the challenges of provision of specialist services over distance, providing remote teleconference support for both patients and clinicians. Expanded national clinical guidelines and standards will support clinicians and promote equity in service delivery. The implications of this paper: Without service innovation, the deterioration in health seen in young adults with chronic conditions as they transition from childhood to adulthood will continue, wasting the gains accrued in recent decades with the focus on children's services. Greater transparency and use of clinical indicator data can inform and support service planning in line with community needs. Greater alignment of services to the needs of adolescents and young adults, and greater support for clinicians in meeting these, offers opportunities for both improved young adult outcomes and better staff satisfaction and retention.