22 And nowadays, it’s also possible with artificial intelligence to make texts or make difficult texts simpler. The digital future can help us a lot, but we still have to communicate with our patients and coaching will also be still very important. 4.5 Follow-up care After catheterisation has been learned, short-term follow-up is needed in the beginning to coach the child and its parents, to ensure that the procedure is being carried out properly, and to provide advice in case of any problems. This can take place in an outpatient clinic, by telephone, by email or using digital aids like Skype, Zoom or hospital video consults. 31 It is important to inform the child and the parents about the different ways of contacting help and advice should they need it to get in touch.36 It can sometimes be necessary to involve home care services or the school nurse. Once catheterisation has become routine, follow-up care can be reduced. As integrating intermittent catheterisation into daily life can be difficult, regular follow-up visits are still a necessity. However, such visits are usually combined with medical appointments. The development and prevention of urinary tract infections can be influenced by the following factors: – Knowledge: discussion of types, sizes, suitability of catheters, new developments on the market, possible medications 18 – Technique: demonstrating catheterisation, practising skills 2,22 – Motivation, perseverance, self-management: 12,38 Follow up should include discussion around these three areas to maximise outcomes. … Recommendations LE GR Support for the child and its parents must be available during the entire catheterisation period 4 C Ensure regular follow-up (in the outpatient clinic, by telephone or via internet) in order to improve QOL with regard to CIC/CISC 4 C Annual follow-up with a nurse practitioner may well help to bring to light any cases of non-compliance 4 C 4.6 Transition Many adolescents with urological disorders need lifelong urological care.40 In recent years, a number of studies have been published about the transition from paediatric urology to adult urology.41-44 These studies have demonstrated that part of the paediatric urology population still consists of adolescents/adults, suggesting that some patients are reluctant to be transferred to adult urology care. General studies have also shown that poor planning/poorly implemented transfer of care leads to avoidance of consultations and non-compliance. A negative effect on morbidity, mortality and social and educational performance has also been demonstrated. Transition is part of growing up and refers to the process of an adolescent patient becoming independent. Transition is defined as a purposeful, planned process to meet the medical, psychosocial and educational needs of adolescents with chronic physical and medical conditions when they move from child-centred to adult-oriented healthcare systems.44 The actual time-point at which a patient moves to adult care is just one part of the transition process and is known as 'transfer'. As adolescents develop into adults, there is a shift in social roles. They form stronger bonds with their peers and become less dependent on their family circle. This shift also takes place with regard to medical care. For young people, letting go of their parents is a developmental milestone. However, having a chronic disorder often reinforces both dependence on parents and parents’ protective behaviour, which makes it harder to reach this milestone and can sometimes create tension.38
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