Abstract 11512: Transition Readiness in Adolescents and Young Adults With Heart Disease: Ready or Not, Here They Come!
Objective: Transition is defined as “the process by which adolescents and young adults with chronic childhood illnesses are prepared to take charge of their lives and their health in adulthood”. The aims of our study were to evaluate transition readiness (TR), including perceived knowledge deficits, self-efficacy, and self-management behaviors, in 13-25 year olds with congenital or acquired heart disease and to examine the relationship between TR dimensions and patient (pt) characteristics and information (info) seeking behavior.
Methods: Patients (n=164) completed the TR Assessment utilizing an e-tablet, web-based format at a routine clinic visit. Following the TR assessment, pts completed a request for info checklist.
Results: Median pt age was 18.1 years (y), sex 60% male. Average perceived knowledge deficit score (% of items with no knowledge) was 25.7% (range 0-75%). Perceived knowledge was generally consistent with actual knowledge examined on selected items (86-90% agreement). On a 100-point scale, the mean score was 72.0 ± 17.2 for self-efficacy and 49.7 ± 17.5 for self-management. Knowledge deficits were negatively correlated with self-efficacy and self-management, all p<.0001. The most common knowledge deficits were related to health insurance (74%; 65% in pts ≥ 18 y), pregnancy (70%; 62% in females ≥ 18 y), contraception (42%; 24% in females ≥ 18 y), how to contact your doctor (37%; 23% ≥ 18 y), symptoms to call for (30%; 25% in pts ≥ 18 y), diagnosis/surgery (27%; 17% in pts ≥ 18 y), and need for life-long care (20%;14% in pts ≥ 18 y). All TR scale scores were significantly better in pts ≥ 18 y (p<.0001) with more knowledge deficits in females (p = 0.01) and lower self-efficacy in pts with single ventricle (p <.05). Overall, 66% of pts requested info (73 % pts ≥ 18 y). Among pts ≥ 18 y who reported knowledge deficits, 40.5% (females) requested info re: pregnancy, and 38% re: symptoms to call for.
Conclusion: Transition knowledge deficits are common and associated with decreased self-efficacy and self-management, suggesting many young adults with heart disease are not adequately prepared for transition to adulthood. The TR assessment identified patient-specific transition needs and can facilitate patient-directed counseling to improve transition outcomes.
- Transitions of care
- Congenital heart disease
- Adult congenital heart disease
- Patient education/teaching psychosocial aspects
- Behavioral aspects
- © 2013 by American Heart Association, Inc.