Many concerns surround the preparation of a person with spina bifida for a successful transition into adult life and responsibilities. A model of intervention must be based on developmental concerns and timely issues from infancy through all stages of development to young-adult life. This article discusses, within a developmental framework, issues of transition in relation to physical, social, emotional, and educational/vocational needs; it also presents a conceptual framework for the transition into adulthood. Guidelines were developed by incorporating expected outcomes of people with spina bifida and using a philosophical framework that encompasses the achievement of a balance among dependence, independence, and interdependence. This model is based on developmental issues from infancy through all stages of development to young-adult life. Using this framework for care, the rehabilitation nurse can feel confident that the needs of clients with spina bifida and similar chronic conditions are being met.
Primary Children's Medical Center, 100 N. Medical Drive, Salt Lake City, UT 84113
Paula Murphy Peterson is the supervisor/PNP of spina bifida services and neurology at Primary Children's Medical Center in Salt Lake City. Karen Kaufmann Rauen is the nurse manager of spina bifida services at St. Michael Hospital in Milwaukee. Jean Brown is director of myelodysplasia services at Shriners Hospital in Greenville, SC. Jeane Cole works as a consultant in Orlando. FL, on the Agent Orange Class Assistance Program of the Spina Bifida Association of America.