The role of observation within a project aiming at facilitating the transition of young patients with juvenile diabetes from paediatric to adults’ services

Abstract

ABSTRACTIn recent years, the spread of juvenile diabetes has increased exponentially causing major psychological, economic and social costs and raising concern among health professionals and policy makers in relation to supporting these children and adolescent patients. The patients’ transition from Paediatric to Adult services is a critical moment with a high percentage of treatment drop-outs. This has been the focus of research carried out by a team of paediatricians, adult diabetologists, and child and adolescent psychotherapists in the Medical School of a large Italian city. This paper focuses on the role of psychoanalytical observation applied in work discussion seminars with the staff of Paediatric and Adult services in the hospital. The observations were conducted in the joint outpatient clinic, a new Service introduced experimentally to facilitate the transfer from Paediatric to Adult Dibetology Clinics. The seminars included the diabetologist for the last paediatric medical appointment and a paediatrician for the first young adult appointment. The paper discusses the methodology and the data gathered, focussing on the dynamics between the two doctors in the joint outpatient clinic, and on the impact of the social defences, which initially interfered with the joint work.