Health Assessment of Chinese Adolescents with Epilepsy in the Preparatory Phase of Transition Process from Pediatric to Adulthood:A Single-Center Study Using the Omaha System.

ABSTRACT

OBJECTIVE: Epilepsy is one of the most common childhood-onset neurological disorder characterized by both seizures and the related comorbidities. The preparatory phase in transition refers to a dynamic process of identifying and resolving health issues to ensure seamless continuing care from childhood to adulthood. This study identifies the health issues of the preparatory phase in transition from children to adulthood using the Omaha System. METHODS: This prospective, single-center study enrolled 86 adolescents with epilepsy in China. The Problem Classification Scheme and Problem Rating Scale for Outcomes of Omaha System were used to evaluate transition-induced health problems. RESULTS: These health problems cover all four domains of the problem classification scheme of the Omaha System, and the specific distribution is related to the type of epilepsy. The results of the four-category classification evaluation showed that the most common health problem is health-related behavioral problems (46.1%), followed by psychosocial problems (23.0%), physiological problems (20.6%), and environmental problems (10.3%). The distribution of these health problems in generalized seizures, focal seizures, and generalized-focal seizures are significantly different (P < 0.01). The results of the outcome rating scale showed that 83.4% of the children had minimal knowledge, 84.2% had inconsistently appropriate behaviors, and 86.7% had moderate symptoms. CONCLUSIONS: The health problems of patients with epilepsy during the preparatory phase of transition process from pediatric to adulthood should be emphasized. Identification of health problems though the Omaha System can improve management for adolescents with epilepsy, including prevention, nursing care, social support, and therapeutic interventions.