Learning objectives
In this chapter you will:
• Develop an understanding of some common chronic conditions experienced by children and young people in Australia
• Review evidence-based symptom assessment and interventions associated with common chronic conditions experienced by Australian children and young people • Consider the developmental needs of children and young people in planning and implementing nursing care for chronic medical conditions
• Explore some of the educational, social and emotional challenges children and young people with chronic conditions face, specifically the transition to adult health-care services
Introduction
As a paediatric nurse, you will frequently care for children and young people with chronic conditions. Your initial contact may be during routine assessment, at diagnosis or during subsequent treatment (such as for the management of childhood cancers or type 1 diabetes). You may also be part of a team managing an acute illness in a child or young person with a chronic condition, as might occur during an exacerbation of asthma or a urine infection in a child with spina bifida. Depending on your role, your involvement may extend to a clinic, home, school or community – for example, if you are running a healthy weight program. If you work within one organisation or within one specialty practice for any period of time, you may form long-term relationships with chronically ill children and their families, becoming part of their lives as they grow into young people and adults – or, inevitably for some, until the end of their lives.
It is not usual to associate children and young people with chronic conditions, especially as some definitions relating to adult illness (such as cardiac disease) imply that chronic diseases are those for which action can be taken to prevent their occurrence (ABS, 2015a). However, the most recent available estimates indicate that between 2007 and 2008, 37 per cent of children and young people in Australia had at least one long-term chronic condition. This figure equates to more than 1.5 million future Australian adults (ABS, 2009). Asthma, diabetes and cancer are the most common chronic medical conditions affecting children in Australia, collectively accounting for 20 per cent of the burden of disease among children aged 0–14 years (AIHW, 2012), but the range of chronic conditions affecting children and young people is much broader.