As adolescents transition to adult-oriented care, it is also essential that they understand both their past medical history and current health care needs. It has been demonstrated that many young people with JIA score poorly on arthritis related knowledge (62), even long-term clinic attendees (63). Effective transitional care has shown to improve such knowledge (55). Thus, assisting the young person to be able to communicate their health care disease and needs is essential. Creating a health summary is one way that adolescents can prepare themselves for the transition to adult-oriented care (e.g., "My Health Passport" at www.sickkids.on.ca/ myhealthpassport/). Numerous templates and tools such as youth health autonomy check lists are available to help youths and providers develop written health care transition plans and portable medical summaries and templates for medical visits. Examples of these can be found on the websites listed in Table 2.
As mentioned in Chapter 4, health care providers need to use age-appropriate preventive care approaches and be mindful of the risk-taking activities and the growing sexuality of the young person with rheumatic disease. In addition, young people with chronic illnesses may be at increased risk for developing mental health problems. Underdiagnosis of treatable psychiatric conditions such as anxiety and depression can be a common occurrence. It is important to question adolescents and their families about any physical symptoms of anxiety and depression, such as altered sleep and appetite. Excessive school absence is also a red flag.
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