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Transition in endocrinology 

Transition in endocrinology
Chapter:
Transition in endocrinology
Author(s):

Helena Gleeson

DOI:
10.1093/med/9780199235292.003.7145
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date: 19 November 2019

Adolescence represents the process of becoming an adult. It involves significant biological, psychological and social changes. Transition has been defined as ‘a multi-faceted, active process that attends to the medical, psychosocial and educational/vocational needs of adolescents as they move from child to adult centred care’. There is an increasing focus on improving adolescent healthcare and transition. It is now recognized that adolescents have particular healthcare needs, and that these should be addressed to provide effective management and transition to adult endocrine care.

Growing up with any chronic condition can affect adolescent development, for instance, pubertal and growth delay and failure to reach peak bone mass, delayed social independence, poor body and sexual self-image, and educational and vocational failure. Conversely, normal adolescent development can make chronic condition management problematic through poor adherence to medical regimens and risky health behaviours.

Much of endocrine care and research in adolescence focuses on optimizing hormone replacement therapy to try and normalize or maximize biological aspects of adolescence, growth and puberty in early and mid-adolescence, and peak bone mass and reproductive potential in late adolescence and young adulthood. Despite certain groups of young people with endocrine conditions having documented psychological and social consequences of growing up with this condition, current endocrine practice does little to address these and minimal research has been done into interventions to improve this. For healthcare professionals to engage adolescents effectively, psychological and social aspects need to be considered and studied and communication skills need to be improved.

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