Transitionsmedizin: Umgang mit Non-Adhärenz und motivierende Gesprächsführung bei chronisch kranken Jugendlichen und jungen Erwachsenen

In pediatric and adolescent medicine, there has been a shift in recent years from the care of acute diseases to the management of chronic diseases. These»new morbidities« are often associated with psychological distress and require long-term treatment. The prognosis depends on lifestyle adjustments to the disease. The health care system and treatment providers often face limitations in accompanying health-related behavior change processes, especially during adolescence and young adulthood. Non-adherent behaviors occur more frequently at this age that may lead to a risk for long-term health problems. Therefore, it is of importance to stay in contact with young patients and to create an environment in which inner conflicts and ambivalence about health-related behavioral changes can be addressed. Facing the limited time in routine medical care, motivational interviewing is a helpful counseling approach to conduct a person- and goal-oriented conversation about possible behavioral changes with ambivalent patients at eye level. The basics of this counseling approach and a brief overview of the evidence on motivational interviewing in the treatment of chronically ill adolescents and young adults will be presented.