Spaces of well-being among young adults with physical disabilities transitioning from pediatric to adult healthcare

Abstract

BackgroundYouth with disabilities are at risk of poor health outcomes as they transition to adult healthcare. Although space and place play an important role in accessing healthcare little is known about the spatial aspects of youth's transition from pediatric to adult healthcare. ObjectiveTo understand the spaces of well-being as youth with physical disabilities transition from pediatric to adult healthcare. MethodsThis study draws on a qualitative design involving 63 in-depth interviews with young adults (n = 22), parents (n = 17), and clinicians (n = 24) involved in preparing young adults for transition. All participants were recruited from a pediatric rehabilitation hospital within a metropolitan area of Ontario, Canada. Data were analyzed using an inductive content analysis approach that was informed by the spaces of well-being framework. ResultsThe results highlight that within the ‘spaces of capability’ those with more disability-related complications and/or those using a mobility device encountered challenges in their transition to adult care. The ‘spaces of security’ influencing youth's well-being during their transition included: temporary (in)security while they were away at college, and health (in)security. Most of the focus on youth's transition included ‘integrative spaces’, which can enhance or hinder their well-being. Such spaces included: spatial (dis)connections (distance to access care), embeddedness (family and community), physical access, and distance. Meanwhile, therapeutic spaces involved having spaces that youth were satisfied with and enhanced their well-being as they transitioned to adult care. ConclusionsIn applying the spaces of well-being framework, the findings showed that youth had varied experiences regarding spaces of capability, security, integrative, and therapeutic spaces.