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Systematic Review of Factors Affecting Transition Readiness Skills in Patients with Inflammatory Bowel Disease
Lara E Johnson1, Matthew J Lee2,3, Rhys Turner-Moore4
1University of Sheffield, Medical School, Sheffield, UK.
Insights
Factors like age, self-efficacy, and communication significantly impact transition readiness skills in adolescents with inflammatory bowel disease (IBD). Addressing these can improve healthcare transitions for young IBD patients.
Area of Science:
- Pediatric Gastroenterology
- Adolescent Health
- Healthcare Transition
Background:
- Rising global incidence of inflammatory bowel disease (IBD) diagnosed in pediatric patients.
- The critical need for specialized skills during the transition from pediatric to adult healthcare for IBD patients.
Purpose of the Study:
- To identify key factors influencing the transition readiness skills of adolescent IBD patients.
- To inform interventions for improving healthcare transitions in IBD.
Main Methods:
- Systematic review of studies published since 1999, focusing on factors affecting transition readiness in IBD patients.
- Searches conducted across MEDLINE, CINAHL, and PsychINFO databases.
- Quality assessment using Joanna Briggs Institute critical appraisal tools.
Main Results:
- Age positively correlated with disease knowledge and self-management behaviors.
- Increased self-efficacy was linked to better disease knowledge, self-management, and quality of life, while negatively correlating with depression and anxiety.
- Female patients reported higher self-management scores; improved communication enhanced knowledge and readiness.
Conclusions:
- Identified modifiable factors can be targeted to support transitioning IBD patients.
- Recognizing non-modifiable factors associated with poor readiness can guide personalized support strategies.
Background And Aims:
The incidence of inflammatory bowel disease [IBD] diagnosed before adulthood is increasing worldwide. Transition from paediatric to adult health care requires certain skills. The aim of this study was to identify factors affecting these skills.
Methods:
This review was registered on the PROSPERO database [CRD42019152272]. Inclusion criteria were: 1] studies of factors affecting transition readiness skills in patients with IBD; 2] written in English; 3] published since 1999. MEDLINE, CINAHL, and PsychINFO databases were searched between 1999 and 2019. Quality was assessed using the Joanna Briggs Institute critical appraisal tools.
Results:
Searches identified 822 papers. Sixteen papers were included. Age was positively associated with skills including disease knowledge and performing self-management behaviours [14 studies]. Improvement often occurs at 18; however, skill deficiency may still remain. Increased self-efficacy [confidence] was associated with greater disease knowledge and performing self-management behaviours [three studies]. Self-efficacy was positively correlated with transition duration [two studies] and health-related quality of life [r = 0.57, p <0.001] [one study], negatively correlated with depression [r = -0.57, p <0.001] and anxiety [r = -0.23, p = 0.03] [one study], and was associated with higher education level [two studies] and a family history of IBD [one study]. Females had higher self-management scores [three studies], and greater health care satisfaction was significantly associated with higher knowledge [one study]. Greater transition communication improved knowledge, self-management, and overall transition readiness [two studies].
Conclusions:
Potentially modifiable factors have been identified that could be supported in the transitioning IBD population, to improve transition readiness. Identification of those with non-modifiable characteristics associated with poor readiness may aid targeted support.
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