The transition of adult patients with childhood-onset chronic diseases from pediatric to adult healthcare systems: a survey of the perceptions of Japanese pediatricians and child health nurses

Three-fourths of the pediatricians and all of the nurses reported that transition programs were necessary. A higher proportion of the nurses realized the necessity of transition and had already developed such programs. Both pediatricians and nurses reported that a network covering the transition from pediatric to adult healthcare services has not been established to date.It has been suggested that spreading the importance of a transition program among pediatricians and developing a pediatric-adult healthcare network would contribute to the biopsychosocial well-being of adult patients with childhood-onset chronic disease.Advances in medicine have dramatically improved the prognosis for children with chronic diseases that were previously fatal in childhood and have allowed them to survive to adulthood [1-3]. In Japan, 1,000 patients with childhood-onset chronic disease (CCD) attain adulthood every year, and many of them do not have serious sequelae or disabilities [4]. These high survival rates have increased the number of adolescents confronting the issue of transition from pediatric to adult healthcare [2,3,5-11]. In addition, the prevalence of some kinds of chronic illnesses in childhood is increasing [5]. These adolescent patients are still developing socially, and they often lack social experiences because of their childhood disease and have difficulties in adapting to both adult social life within their community and adult healthcare systems [12]. Therefore, programs are required to ensure a seamless transition of medical care in childhood and adolescence to that in adulthood and to help children grow socially and become independent, working adults.The transition of young people with CCD and disability from pediatric to adult healthcare has recently received significant attention in literature. Transition has been defined as a multi-faced, active process that attends to the medical, psychosocial, and educational needs of adolescents as they move from child to ad