185 Q-Care Profiles: Development of a New Instrument to Stimulate Communication with Adolescents with Chronic Disorders During Consultations

Abstract

Background: A previous Q-methodological study revealed four distinct preference profiles for health care delivery and self-management: ‘Conscious & Compliant’; ‘Backseat Patient’; ‘Self-confident & Autonomous’; and ‘Worried & Insecure’.Aim: 1) To examine the prevalence of Q-care profiles (QCP); 2) To explore the associations with adolescent characteristics and 3) Develop an attractive tool for communication during consultations. Methods: Web-survey among all chronic patients (12-19 yrs) of a paediatric hospital and their parents. Adolescents' fit to the Abbreviated QCP descriptions was scored on a five-point Likert-scale.Results: 990 adolescents and 778 parents responded. Adolescents recognize themselves twice as often in the ‘Conscious & Compliant’ profile than in the other profiles. Fit to any of the profiles is associated with age, gender, quality of life, impact of disease, self-efficacy, independent behaviour and readiness for transition. While the ‘Backseat Patient’ and the ‘Worried & Insecure’ type feel less self-efficacious, the ‘Self-confident & Autonomous’ type is at risk for non-adherence. Parents & children's assessments correspond fairly well, but there are significant differences.Conclusions: The Q-care profiles are recognizable to adolescents and parents, and they discriminate fairly well. The QCP seem potentially suitable to stimulate communication with adolescents. A practical manual for use of QCP during consultations was developed, including tips for interventions to be used by healthcare providers to address typical problems associated with each profile. Further research into the applicability of this new tool and the possibility to use the Q-care profiles as a screening instrument for self-management failure is now underway.