P365: A CONCEPTUAL MODEL FOR TRANSITION
Liesbeth Verhoeven, J.van der Laag
CF-centre Utrecht, University Medical Centre (UMC), Utrecht, The Netherlands

Transition of adolescents from paediatric to adult CF care always remains difficult, as well for the patients themselves and their parents, as for the individual caregivers. For better insight into the ideas of the patients concerned we performed a thorough literature study and conducted interviews with sixteen patients and their parents one year after the transition. Based on these data we developed a model that may be helpful for the transition-process.

Caregivers in the UMC use a "step" to bridge the distance between the children's hospital and the hospital for adults. The vehicle is presented as a conceptual model for the process of transition.

Preparations have to be made by the multidisciplinary team in the children's hospital, presented by the back wheel. The aims are to support the adolescent in taking responsibility for his/her health-condition and to support their parents in the process of "let go".

Transfer is the middle part, when all preparations have been made and members of the multidisciplinary team transfer their part of the care to their colleagues of the team for adult healthcare givers. Adaptation to the CF-team for adults is represented in the front wheel. The aim of this adaptation is to develop participation in all aspects of the disease-management by the young adult.

The parents are also taking part in the transition-process. However, their role has changed. They become the "vocal backing-group" and take their place behind the adolescent.

The individual adolescent makes the speed of the whole process. Depending on other developments in his/her life, transition may be a fast or a slow process. Every adolescent has his own medical history. Therefore a basket is placed on the front wheel. When the process of transition has been finished, an evaluation follows, including the opinion of the young adult, the parents and the members of both multidisciplinary teams.

Conclusion:
using this model of transition, all stages of the process are clear. The persons involved exactly know their roles. A transition-programme built on this model may give structure to the transition-process.