[A difficult transition from childhood to adult healthcare: The case of XXXX .]

@entity1 @entity16 @entity302
OBJECTIVE: The purpose of this study was to analyze modalities of the transition from pediatric to @entity302 care and @entity1 ' acquisition of autonomy. METHOD: This study was conducted using semidirected interviews composed of three major parts: the @entity1 's criteria of transition toward adult healthcare (factors taken into account, anticipation, the @entity1 's opinion, etc.), conditions (teamwork with the neurologists, transmission of the medical record, continuity of health care, etc.), and the role played by social workers and psychologists. We interviewed 10  doctors belonging to six major Parisian hospital units involved in the monitoring of @entity1 and adolescents with @entity302 and working in Pediatric Neurology Departments of the   le-de-France region. RESULTS: For most of the doctors, reaching 18 years of age was the major argument taken into account to consider transition to adult care. According to the doctors interviewed, parents are generally worried when their @entity1 has to find another doctor (7/10). According to eight out of 10  doctors, the neurologist is selected to take over. The doctors recognize the importance of psychologists and social workers even if they are not always included. The process by which the @entity1 gains autonomy depends a great deal on the role played by the pediatricians and parents, although some parents are very protective. This behavior weakens the @entity1 's capacity for autonomy and it varies according to the degree of his or her physical and/or @entity16 . Furthermore, developing autonomy requires interdisciplinary work that is not yet fully in place. CONCLUSION: The lack of structures well-adapted to the uniqueness of each @entity1 and the lack of coordination between the various institutions do not favor the acquisition of autonomy. A network that could efficiently respond to the needs of @entity302 @entity1 as well as medical care tailored to adolescents would be the answer to this dilemma.
