A Systematic Review of Transition Readiness in Youth with Chronic Disease

Varty, Maureen; Popejoy, Lori

doi:10.1177/0193945919875470

Cited by 44 publications

(30 citation statements)

References 71 publications

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“…Increasing transition readiness has been proposed as a mechanism for improving health outcomes after transition. Despite increasing research on transition readiness, few nonmodifiable and modifiable factors associated with transition readiness have been tested across multiple chronic disease populations (Varty & Popejoy, 2020). In particular, for AYAs living with SCD, limited research on transition readiness has been conducted that delineates essential modifiable factors essential to the development of interventions tailored to this chronic disease population.…”

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Decision-Making Involvement, Self-Efficacy, and Transition Readiness in Youth With Sickle Cell Disease

et al. 2021

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Background: Transition to adult healthcare is a critical time for adolescents and young adults (AYAs) with sickle cell disease, and preparation for transition is important to reducing morbidity and mortality risks associated with transition.Objective: We explored the relationships between decision-making involvement, self-efficacy, healthcare responsibility, and overall transition readiness in AYAs with sickle cell disease prior to transition.Methods: This cross-sectional, correlational study was conducted with 50 family caregivers-AYAs dyads receiving care from a large comprehensive sickle cell clinic between October 2019 and February 2020. Participants completed the Decision-Making Involvement Scale, the Sickle Cell Self-Efficacy Scale, and the Readiness to Transition Questionnaire. Multiple linear regression was used to assess the relationships between decision-making involvement, self-efficacy, healthcare responsibility, and overall transition readiness in AYAs with sickle cell disease prior to transition to adult healthcare.Results: Whereas higher levels of expressive behaviors, such as sharing opinions and ideas in decision-making, were associated with higher levels of AYA healthcare responsibility, those behaviors were inversely associated with feelings of overall transition readiness. Self-efficacy was positively associated with overall transition readiness but inversely related to AYA healthcare responsibility. Parent involvement was negatively associated with AYA healthcare responsibility and overall transition readiness.Discussion: While increasing AYAs' decision-making involvement may improve AYAs' healthcare responsibility, it may not reduce barriers of feeling unprepared for the transition to adult healthcare. Facilitating active AYA involvement in decisionmaking regarding disease management, increasing self-efficacy, and safely reducing parent involvement may positively influence their confidence and capacity for self-management.

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Decision-Making Involvement, Self-Efficacy, and Transition Readiness in Youth With Sickle Cell Disease

et al. 2021

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“…The feeling that they could manage adult life with the disease therefore diminished. This is a major finding since, as shown by Varty and Popejoy (2020), self-efficacy is the most mentioned psychosocial influencing factor of transition readiness according to the literature.…”

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confidence: 76%

“…I am writing regarding the article published in the July 2020 issue of Western Journal of Nursing Research , titled “A systematic review of transition readiness in youth with chronic disease” (Varty & Popejoy, 2020).…”

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confidence: 99%

Letter to the Editor

Morsa¹

2020

West J Nurs Res

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“…Adult psychiatrists seem to be keener on supporting this newly acquired autonomy (the subtheme “Supporting the patient’s autonomy before and after the referral” being by far the most represented among adult psychiatrists in the whole dataset), including social aspects such as housing or finances. Autonomy is a cornerstone of the transition process and should be a priority target in potential transition interventions: factors related to patient’s autonomy, such as self-efficacy or responsibility in disease management are indeed significantly associated with transition readiness [ 39 ]. This is in line with the fact that autonomy level is perceived by our participants as the most adequate criterion to engage in transition.…”

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Adult and child and adolescent psychiatrists' experiences of transition in anorexia nervosa: a qualitative study

et al. 2022

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Background Young patients suffering from anorexia nervosa (AN) frequently need further treatment in Adult Mental Health Services (AMHS). The transition period from Child and Adolescent Mental Health Services (CAMHS) to AMHS is a critical time, with a high risk of disengagement from healthcare. We explored physicians’ perspectives of the transition to triangulate the multiple perspectives of physicians, parents and those with a lived AN experience to more comprehensively characterize the challenges in this process of treatment transition. Methods Using purposive sampling, we recruited 16 physicians confronted with transition in AN (adult psychiatrists, child and adolescent psychiatrists and pediatrician) and conducted semi-structured interviews, which were anonymized, transcribed, and analyzed following the reflexive thematic analysis framework. Results Our analysis produced three main themes. First, a shared agreement on the transition’s malfunction, where participants depicted transition as a dissatisfying, violent event. Second, the conception of AN as a disorder with specific needs, challenging the transition process especially regarding physicians’ engagement. Finally, the ideal transition conceived as a serene experience of separation, with unanimous agreement on the necessity to start the transition depending on patients’ needs rather than their age, in order to turn transitions into moments of care. Conclusion Our results are in line with other qualitative research studying transition in AN and in other chronic diseases, either focusing on the experience of healthcare workers, families, or patients. Our research shows transition in AN as an anxiety-inducing experience for physicians, patients and families alike. Moreover, we highlight a gap in the way physicians perceive and assist the patient’s greater autonomy, depending on their specialty. Helping physicians to manage their patient’s autonomy, which is a cornerstone of the transition readiness concept, could be a very efficient way to improve transitions in AN. Plain English summary Anorexia Nervosa (AN) is a severe disease, which most of the time starts during adolescence. Transition from Child and Adolescent Mental Health Services to Adult Mental Health Services is at risk of disengagement from healthcare. In order to better understand this process, we interviewed expert physicians about their experiences of transition in AN using a qualitative thematic analysis which highlighted three main themes. First, a shared agreement on the transition’s malfunction. Second, the conception of AN as a disorder with specific needs challenging the transition process. Finally, the ideal transition conceived as a serene experience of separation, which needs to be started depending on patients’ needs rather than their age. We also show differences in the way physicians perceive and assist the patient’s greater autonomy acquired during the transition. Helping physicians to support their patients in acquiring autonomy, which is a cornerstone of the transition readiness concept, could be a very efficient way to improve transitions in AN.

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A Systematic Review of Transition Readiness in Youth with Chronic Disease

Cited by 44 publications

References 71 publications

Decision-Making Involvement, Self-Efficacy, and Transition Readiness in Youth With Sickle Cell Disease

Decision-Making Involvement, Self-Efficacy, and Transition Readiness in Youth With Sickle Cell Disease

Letter to the Editor

Adult and child and adolescent psychiatrists' experiences of transition in anorexia nervosa: a qualitative study

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