College of Science and Health Theses and Dissertations

Date of Award

Winter 3-20-2020

Degree Type

Dissertation

Degree Name

Doctor of Nursing Practice (DNP)

Department

Nursing

First Advisor

Kim Amer, PhD, RN

Second Advisor

Zehra Kanji-Ghaziani, DNP, FNP-BC

Abstract

The transition from pediatric to adult healthcare has become healthcare concern of increasing importance as more adolescents with chronic conditions survive to adulthood requiring continuing care. In order to understand the current status of healthcare transition (HCT), we identified the HCT services received by young adults, their existing healthcare self-management skills and how skills correlated with their quality of life. A correlational and retrospective cross-sectional online survey of English-speaking young adults in the United States ages 18-26 with at least one pediatrically diagnosed chronic condition was conducted August-October 2019. Participants completed a healthcare transition feedback survey, the TRANSITION-Q self-management skills evaluation and the PedsQL Well-Being and Generic Core Measures quality of life surveys. A total of 72 completed survey responses were included in the final analysis with a participant group that reported 26 pediatrically diagnosed chronic conditions; the three most reported conditions were asthma (n = 16), diabetes (n = 17), and cystic fibrosis (n = 8). A majority (54.2%) of participants indicated that they felt “very prepared” to transition to adult care and the average TRANSITION-Q skills score (25.51, SD = 6.45) was only 65.4% of the maximum possible score. Increased TRANSITION-Q scores were associated with increased trust and interaction in patient-provider relationships during HCT. A small negative correlation was found between TRANSITION-Q scores and Generic Core measure quality of life scores (r = -0.27, p = 0.026). Participants with cystic fibrosis showed increases quality of life scores with more independence in selected self-management skills compared with participants with asthma, diabetes, and the overall sample which demonstrated decreases. This study demonstrates the continuing nature of HCT into young adulthood and that interactions which build rapport and trust with a pediatric healthcare provider increase the acquisition of self-management skills. The relationship between self-management skills and quality of life is related to condition type and further research is needed to outline the relationship.

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