Longitudinal Self-Management and/or Transition Readiness per the TR
Yi Zhong1, Donna B Gilleskie1, Miranda A L van Tilburg2
1Department of Economics, University of North Carolina at Chapel Hill (UNC), Chapel Hill.
The Journal of Pediatrics
|September 12, 2018
Summary
Healthcare transition (HCT) readiness and self-management skills (SMS) improve with age, but gains slow in older individuals. Parental education and insurance status influence skill development, highlighting the need for tailored support.
Area of Science:
- Pediatric healthcare research
- Chronic condition management
- Health services research
Background:
- Healthcare transition (HCT) and self-management skills (SMS) are crucial for adolescents and young adults with chronic conditions.
- Longitudinal data is needed to understand factors influencing HCT readiness and SMS development.
- The TRxANSITION Index measures learning outcomes relevant to HCT and SMS.
Purpose of the Study:
- To identify individual, family, and illness characteristics affecting HCT readiness and SMS levels and gains.
- To analyze longitudinal changes in HCT/SMS over time.
- To inform targeted interventions for improving patient preparedness for adult healthcare.
Main Methods:
- Longitudinal observational study of 566 adolescents and young adults with chronic conditions.
- Utilized the TRxANSITION Index for repeated measurements of HCT/SMS.
- Employed an education-based analytical approach to assess skill acquisition.
Main Results:
- HCT/SMS scores and gains increased with age, with diminishing returns at older ages.
- Skill mastery, particularly self-management, was often achieved after age 20.
- Father's education positively correlated with scores, while mother's education and diagnosis duration showed negative correlations. Private insurance was linked to greater gains.
Conclusions:
- Age is a significant factor in HCT/SMS development, with younger patients and those with more educated mothers showing smaller gains.
- Risk factors for absolute skill levels differ from those affecting skill gains, necessitating a nuanced understanding.
- Findings guide providers in tailoring HCT/SMS preparation based on age-specific skill acquisition and identifying at-risk patients.
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