Abstract
BackgroundFor many young people with long term conditions (LTC), transferring from paediatric to adult health services can be difficult and outcomes are often reported to be poor. We report the characteristics and representativeness of three groups of young people with LTCs as they approach transfer to adult services: those with autism spectrum disorder with additional mental health problems (ASD); cerebral palsy (CP); or diabetes.MethodsYoung people aged 14 years-18 years 11 months with ASD, or those with diabetes were identified from children’s services and those with CP from population databases. Questionnaires, completed by the young person and a parent, included the ‘Mind the Gap’ Scale, the Rotterdam Transition Profile, and the Warwick and Edinburgh Mental Wellbeing Scale.ResultsThree hundred seventy four young people joined the study; 118 with ASD, 106 with CP, and 150 with diabetes. Participants had a significant (p < 0.001) but not substantial difference in socio-economic status (less deprived) compared to those who declined to take part or did not respond. Condition-specific severity of participants was similar to that of population data.Satisfaction with services was good as the ‘gap’ scores (the difference between their ideal and current care) reported by parents and young people were small. Parents’ satisfaction was significantly lower than their children’s (p < 0.001). On every domain of the Rotterdam Transition Profile, except for education and employment, significant differences were found between the three groups. A larger proportion of young people with diabetes were in a more independent phase of participation than those with ASD or CP. The wellbeing scores of those with diabetes (median = 53, IQR: 47–58) and CP (median = 53, IQR: 48–60) were similar, and significantly higher than for those with ASD (median = 47, IQR: 41–52; p < 0.001).ConclusionsHaving established that our sample of young people with one of three LTCs recruited close to transfer to adult services was representative, we have described aspects of their satisfaction with services, participation and wellbeing, noting similarities and differences by LTC. This information about levels of current functioning is important for subsequent evaluation of the impact of service features on the health and wellbeing of young people with LTCs following transfer from child services to adult services.
Highlights
For many young people with long term conditions (LTC), transferring from paediatric to adult health services can be difficult and outcomes are often reported to be poor
Summary of findings and interpretation This paper explores satisfaction with services, participation and wellbeing in three representative groups of young people with long term conditions who were close to transfer to adult services
It is not known to what extent the poor health status and levels of social functioning were present before transfer to adult services
Summary
For many young people with long term conditions (LTC), transferring from paediatric to adult health services can be difficult and outcomes are often reported to be poor. The need to transfer from child-centred to adult oriented healthcare systems is part of the wider set of tasks that young people with LTCs need to negotiate. In this context ‘transition’ is a wider concept than transfer and defined as ‘the purposeful, planned process that addresses the medical, psychosocial, educational and vocational needs of adolescents and young adults with chronic medical and physical conditions’ [14]. It is not known to what extent such poor outcomes were already present before transfer to adult services because there is a lack of longitudinal research exploring the experiences of young people before, during and after healthcare transfer [9]
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