Original articleReadiness to Transfer to Adult Care of Adolescents with Chronic Conditions: Exploration of Associated Factors
Section snippets
Participants
The target group was selected from the hospital database, which consisted of all adolescents who were aged 12–19 years and who in mid-2006 were under active long-term treatment for a somatic chronic condition either in the Department of Pediatrics or the Department of Pediatric Surgery at the Erasmus MC-Sophia Children's Hospital. Inclusion criteria included the following:
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Before July 1, 2006, the adolescent should have been under treatment for >3 years;
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The adolescent should have made outpatient
Study population
Of the original sample of 3,861, a total of 213 subjects were not included in the study because they either met the exclusion criteria (179 intellectual disabilities; four already transferred) or inadvertently did not receive the letter (n = 30). Therefore, a total of 3,648 formed the study population (Figure 1). A response was received from 1,318 adolescents (36.1%). However, 231 of them returned the response card explaining why they could not participate in the study: of these, 144 (62.3%)
Discussion
This study investigated factors that might be associated with perception of being ready to transfer to adult care. Age proved to be an important factor in this sense, whereas other socio-demographic variables and disease-related factors (including quality of life) did not prove to be important. Moreover, adolescents' attitude toward transition and their level of self-efficacy in managing day-to-day self-care and in hospital consultations were strongly associated with TR.
Similar to our study,
Conclusion
Apart from age, adolescents' attitude toward transition, and their level of self-efficacy in managing day-to-day self-care and hospital consultations seem to be the keystones to TR. Strengthening adolescents' independence and self-management competencies, combined with early preparation and repeated discussions about the forthcoming transition, seems to be a useful strategy in increasing adolescents' readiness to transfer.
Acknowledgments
This work was supported by a grant from the Dutch charity foundation Kinderpostzegels (no. 23764/1/4). The authors thank all young people who participated in the study. They also thank all members of the advisory board, who provided advice at all stages of the research, and to Mathilde Strating, Adriaan Visser, Margo Trappenburg, and Ko Hagoort for valuable comments on earlier drafts of this paper.
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