Background or Introduction
At the beginning of the article, the authors introduce the topic and the background information. The description of children and adolescents care details are given. Management of care is defined as an essential part of treatment that cannot be neglected by healthcare providers. It is also mentioned that diabetes could affect a human life from different perspectives including the fact that the choice of a lifestyle and self-management (de Beaufort et al., 2010).
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The main goal of the project is to gather information about different practices healthcare professionals could offer to patients with diabetes and the changes that occur from the pediatric to adult diabetes care transition (de Beaufort et al., 2010). Such a project should help to clarify the evaluations and assessments to be performed in the future to improve the transition process and meet the needs and expectations of the patients and their families.
Review of the Literature
It is mentioned that “optimal metabolic control and quality of life” are the main purposes in the care of children and adolescents with diabetes (de Beaufort et al., 2010, p. 24). This information is taken from the article of Blum written in the middle of the 1990s. The studies of Weissberg-Benchell, Wolpert, Anderson, and Viner are also used to describe the general state of affairs that could be observed among the patients with diabetes. This review of the literature proves that the chosen topic has been already investigated by different people, and the importance of care for people with diabetes cannot be neglected.
Discussion of Methodology
Certain attention is paid to the methods used by the authors to answer the main question concerning the importance of the transition from pediatric to adult diabetes care. A questionnaire was used to identify the transition practices in different parts of the world (de Beaufort et al., 2010). The participants of the questionnaire were the members of the International Society for Pediatric and Adolescent Diabetes (ISPAD). It was decided to use e-mail as the main tool to gather opinions. 578 ISPAD members including physicians, nurses, psychologists, and dieticians were interested in the question of care of diabetes patients (de Beaufort et al., 2010). The same questionnaire was re-sent in four months to increase the response rate.
The essence of the method was as follows: a questionnaire with 21-items was sent to the participants of the study via e-mail. The questions include the information about the health discipline offered to the healthcare workers, the settings where the participants had to work, the age of patients they had to work with, and the specialist who had to take responsibility for the care of patients with diabetes. At the same time, the authors of the article tried to create questions about the transition process itself and the quality of care offered to children and adult patients. Finally, it was necessary to identify the common opinion about the most appropriate age when it was possible to promote the transition from pediatric to adult care and the best practices that could be offered.
In the article under consideration, attention to the data analysis methods was not paid. Still, the results and discussions could be used to investigate the possible methods offered by the researchers. The analysis of the participants of the study was introduced. It was mentioned that the members were the citizens of 36 countries. 88 physicians and 16 nurses responded to the questionnaire. Some of the participants worked at university hospitals, and some of them worked at regional hospitals and national centers.
The analysis of the results showed that the age range of youth differed considerably. Most children (under the age of 12) were followed by a pediatric diabetologist or a pediatrician (de Beaufort et al., 2010). Young adults (children between 12 and 25 years) were under the control of pediatric clinics. Still, about 77% of medical centers did not have diabetes patients below 18 years. The suggestions about the transition age were framed between 14 and 25 years. Still, some centers supported the idea of 18-25 years of age.
It was reported that the transition was the practice that had to be initiated by the representatives of the pediatric unit. Such methods as a phone contact, a letter, and cross-over meetings were offered as the best approaches to promote and support the transition. In many centers, its members underlined that it was better to use several methods at the same time to make sure that the patients and the medical staff had enough information about the current state of affairs.
However, even being aware of such kind of importance, several hospitals and medical centers did not spend much time on the development of special transition programs. As a rule, such programs occurred at the local level and remained to be informal and personal (de Beaufort et al., 2010). Children with diabetes should be identified as a certain group of patients who need care and medical support. The researchers of the study use the quantitative method to prove that children around the whole world could be affected by diabetes, and they have to address the medical organization where appropriate help could be offered.
It is not enough to have some general medical center where children and adults with diabetes could be treated. It is necessary to make sure that medical organizations have enough people to develop appropriate transition programs and techniques to help children and their families to deal with diabetes. The development of such programs is a time-consuming activity, and people should be ready to spend their time and efforts to succeed in the transition from child to adult care.
Critique of Evidence
In general, the researchers’ conclusions are supported by the evidence offered in each section of the article. The authors aimed at describing the current situation when pediatric-adult care transition should occur. They gathered enough opinions, considered the citizens of different countries, and proved that the process of transition was not perfect and had to be improved considerably. Though no section aims at reviewing the literature available on the topic, the first paragraph of the article could serve as the introduction to the study and the analysis of the literature that could be used as the basis of the project.
Explanation of Human Subjects and Cultural Considerations
In the article, human subjects and cultural considerations are defined and protected because the authors decided to wait four months to make sure the participants weighed all pros and cons of their contributions to the study and provided enough information to conclude the worth of the transition process.
Strengths and Limitations
The strength of the article is the identification of the problems in the care transition process and the explanation of the improvements that could be offered to the medical centers in 36 countries. Still, there is also a limitation that includes the inability to understand how the authors analyze the information and combine the results of the questionnaire. The limited sample and sample size should also be mentioned for further researchers to correct this shortage.
Article in Nursing Practice
The article helps to understand that chronic disabilities require a specific way of treatment. Regarding special health care needs and transitions people experience from their childhood to the adult age, it is necessary to clarify the peculiarities of diabetes and the practices that could be offered by medical experts. Diabetes is a problem that bothers several people from different parts of the world, and transitional care has to be properly organized at any stage. The promotion of healthcare strategies and services is an integral part of the modern world, and the transition from the pediatric setting to the adult clinic should be organized in regards to the latest opportunities and patients’ needs.
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de Beaufort, C., Jarosz-Chobot, P., Frank, M., Frank, M., de Bart, J., & Deja, G. (2010). The transition from pediatric to adult diabetes care: Smooth or slippery? Pediatric Diabetes, 11, 24-27.