Medical Transition to a University Setting for Students with Chronic Illnesses

Abstract

Medical Transition to a University Setting for Students with Chronic Illnesses Anna M. Baker (bio), Julia Johnston (bio), Lauralee Davis (bio), and Allison Lockard (bio) Chronic illnesses are defined as any physiological condition that persists for at least 3 months and often does not resolve (Rosina et al., 2003). Growing numbers of young adults with chronic illnesses pursue higher education (Mullins et al., 2017), yet they arrive at college unprepared to manage their conditions (Gray et al., 2018; Schaefer et al., 2017). Many young adults matriculate without knowing how to refill prescriptions on time, navigate health insurance policies, identify providers, and advocate for their needs (Lemly et al., 2014). Medical transfer to a different geographic setting without parental support or self-management skills when beginning college can be a large stressor (Gray et al., 2018; Schaefer et al., 2017). Many universities also struggle to support the medical needs of students; 17% of 51 universities surveyed did not have a campus health center, necessitating transportation for medical services (Lemly et al., 2014). People experiencing chronic illness are at greater risk for anxiety and depression, which may be exacerbated during the transition to college (Wodka & Barakat, 2007). Thus, it is essential to understand whether entering students encounter difficulties managing chronic physical illnesses along with other psychosocial concerns. Of additional concern, students with chronic illness have lower odds of graduating college (Maslow et al., 2011). The literature suggests that students with chronic illness experience barriers that impact their ability to function well in college and university settings. This study aimed to examine how students perceived their medical transfer to a new location, institutional support, and psychosocial functioning. We also specifically wanted to examine whether transfer and transition experiences were related to anxiety, depression, and social support, as these concerns have been noted in the literature as potential problem areas for this population. We hypothesized that students with chronic illnesses would have difficulty with their medical transfer and transition and would experience barriers, including access to medical care and support from the institution. We predicted that difficulty with medical transfer and transition would be related to greater anxiety and depressive symptoms and that higher levels of social support would correlate with lower anxiety and fewer depressive symptoms. [End Page 731] METHOD Participants Participants were 171 students with chronic illness (87% female, 74% White) who were 18–22 years of age and enrolled at a US university. Chronic illness was defined as a condition impacting physical health or mobility; those with illnesses of a psychiatric nature were excluded. A total of 741 participants were recruited as part of a larger study. Some participants were students enrolled in Psychology 100 courses at two northeastern universities and were recruited via an email sent through university accessibility offices. Additional participants were identified through Qualtrics recruitment methods from institutions across the US. The researchers worked with Qualtrics to ensure recruitment of the target population through their database of participants and designed the survey with questions related to inclusion and exclusion criteria built in. Incentives for participation varied by recruitment method and included entry in a raffle for gift cards, a $5.00 payment, credit as part of a course, or online compensation via Qualtrics. Measures Participants completed standard demographic questions such as age, gender identity, race, ethnicity, and class year. Medication transfer and transition were indexed by author-generated questions assessing medical history, illness management, and medical transition and transfer experiences. In addition, students provided open-ended responses to the question, Is there some way that your university, The Office of Accessibility Resources, or Student Health could provide support so that more of your medical needs were addressed, or is there an area where you do not feel you receive adequate support from the institution? Coding categories were independently generated by the second author based on themes from student responses and confirmed with the third author. These two authors then independently coded responses from students. Longer responses including more than one theme were coded into multiple categories. The authors agreed on the coding of 97% of responses (87/90), and disagreements were resolved through discussion. Medical adherence was assessed using the Medical Adherence Rating Scale (MARS; Thompson et al...