Elsevier

Journal of Adolescent Health

Volume 59, Issue 3, September 2016, Pages 345-353
Journal of Adolescent Health

Original article
Views of Young People With Chronic Conditions on Transition From Pediatric to Adult Health Services

https://doi.org/10.1016/j.jadohealth.2016.04.004Get rights and content

Abstract

Purpose

This study sought to identify and describe the views of young people with chronic conditions about the transition from pediatric to adult services.

Methods

Q methodology was used to identify young people's views on transition. A set of 39 statements about transition was developed from an existing literature review and refined in consultation with local groups of young people. Statements were printed onto cards and a purposive sample of 44 young people with chronic health conditions was recruited, 41 remaining in the study. The young people were asked to sort the statement cards onto a Q-sort grid, according to their opinions from “strongly disagree” to “strongly agree.” Factor analysis was used to identify shared points of view (patterns of similarity between individual's Q-sorts).

Results

Four distinct views on transition were identified from young people: (1) “a laid-back view of transition;” (2) “anxiety about transition;” (3) “wanting independence and autonomy during transition;” and (4) “valuing social interaction with family, peers, and professionals to assist transition.”

Conclusions

Successful transition is likely to be influenced by how young people view the process. Discussing and understanding young people's views and preferences about transition should help clinicians and young people develop personalized planning for transition as a whole, and more specifically the point of transfer, leading to effective and efficient engagement with adult care.

Section snippets

Methods

Q methodology combines quantitative and qualitative methods to investigate the range of possible views about a particular subject. Watts and Stenner [22], in their guide to Q methodological work, recommend it where the answer is “Yes” to the questions “Does it really matter what people…think about this issue?” and “Can revelation of their views really make a difference?” It has been used widely with young people [23], [24], [25], [26], including in studies on health and chronic disease

Results

Figure 1 shows the Q-set development process. A total of 200 statements were discarded because they were study context or condition specific, for example, mentioning specific medications or limitations associated with having a particular condition that may not be relevant across all chronic conditions. After consultation with the young people, the Q-set of 39 statements was finalized (see Table 1).

Forty-four participants were recruited between March 2013 and November 2013; 23 female, 21 male;

Discussion

This research is among the first to use Q methodology with young people from across a broad range of chronic health conditions to identify their views about transition. We identified four clearly distinct views toward transition: a relaxed view of the process (F1: “A laid-back view of transition”); an anxious attitude (F2: “anxiety about transition”); a desire for greater responsibility within and outside health (F3: “Wanting independence and autonomy during transition”); and a focus on social

Acknowledgments

The authors would like to thank all the young people who kindly took part in this study. We would also like to acknowledge the clinicians who helped us recruit young people to this study: Alan Anderson, Laura Baines, Steve Ball, Katherine Barlow, William Bliss, Nicola Brown, Su Bunn, Penny Burt, Tim Cheetham, Denise Chisholm, Lucy Craig, Jean Crosier, Anita Devlin, Simon Doe, Peter Dryden, Anna Eden, Rob Forsyth, Helen Foster, Dee Frost, Hany Gabra, Binu George, Helen Hanson, Sally Harding,

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    Conflicts of Interest: The authors have no conflicts of interest or financial disclosures to report.

    Disclaimer: The views expressed in this article are those of the authors and not necessarily those of the NHS, the NIHR, or the Department of Health.

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