Reaching adulthood with Hirschsprung's disease: Patient experiences and recommendations for transitional care

J Pediatr Surg. 2021 Feb;56(2):257-262. doi: 10.1016/j.jpedsurg.2020.05.015. Epub 2020 May 16.

Abstract

Background/purpose: The need for transitional care has gained increased focus in the treatment of patients with congenital colorectal disorders. We aimed to acquire in-depth knowledge about the experiences of adult patients with Hirschsprung's disease (HD) and their suggestions for transitional care.

Methods: Binational study applying gender equal focus group interviews (FGI).

Results: Seventeen (9 men) of 52 invited patients with median age 29 (19-43) years participated. Three themes evolved from the FGI. "Scarred body and soul" describes the somatic and psychosocial challenges the patients experienced and "limited health literacy on HD" refers to the patients' lack of HD knowledge. "Absent transition" depicts missing transitional care and the patients' inability to find adult HD specialists. The adult HD patients strongly recommended transitional care from early teens with focus on information about HD and establishment of a peer-to-peer program. They also emphasized the possibility of being referred to a pelvic floor center.

Conclusions: HD negatively influences patients' somatic and psychosocial health in childhood, adolescence and adulthood. Adult HD patients strongly recommend transitional care from early teens and the possibility for referral to a center working with pelvic floor dysfunctions.

Level of evidence: IV TYPE OF RESEARCH: Clinical.

Keywords: Experiences; Health literacy; Hirschsprung; In-depth interview; Long-term results; Transitional care.

MeSH terms

  • Adolescent
  • Adult
  • Hirschsprung Disease* / therapy
  • Humans
  • Male
  • Patient Outcome Assessment
  • Transitional Care*