Abstract
BackgroundManaging transition of adolescents/young adults with life-limiting conditions from children’s to adult services has become a global health and social care issue. Suboptimal transitions from children’s to adult services can lead to measurable adverse outcomes. Interventions are emerging but there is little theory to guide service developments aimed at improving transition. The Transition to Adult Services for Young Adults with Life-limiting conditions (TAYSL study) included development of the TASYL Transition Theory, which describes eight interventions which can help prepare services and adolescents/young adults with life-limiting conditions for a successful transition. We aimed to assess the usefulness of the TASYL Transition Theory in a Canadian context to identify interventions, mechanisms and contextual factors associated with a successful transition from children’s to adult services for adolescents/young adults; and to discover new theoretical elements that might modify the TASYL Theory.MethodsA cross-sectional survey focused on organisational approaches to transition was distributed to three organisations providing services to adolescents with life-limiting conditions in Toronto, Canada. This data was mapped to the TASYL Transition Theory to identify corresponding and new theoretical elements.ResultsInvitations were sent to 411 potentially eligible health care professionals with 56 responses from across the three participating sites. The results validated three of the eight interventions: early start to the transition process; developing adolescent/young adult autonomy; and the role of parents/carers; with partial support for the remaining five. One new intervention was identified: effective communication between healthcare professionals and the adolescent/young adult and their parents/carers. There was also support for contextual factors including those related to staff knowledge and attitudes, and a lack of time to provide transition services centred on the adolescent/young adult. Some mechanisms were supported, including the adolescent/young adult gaining confidence in relationships with service providers and in decision-making.ConclusionsThe Transition Theory travelled well between Ireland and Toronto, indicating its potential to guide both service development and research in different contexts. Future research could include studies with adult service providers; qualitative work to further explicate mechanisms and contextual factors; and use the theory prospectively to develop and test new or modified interventions to improve transition.
Highlights
Managing transition of adolescents/young adults with life-limiting conditions from children’s to adult services has become a global health and social care issue
The rationale for the transition issue is multifaceted with causes related to a disjointed transition process [4], adolescents/young adults experiencing difficulties adjusting to differences in the culture between children’s and adult services [5], the ending of long-standing relationships with children’s service providers, and loss of services [6]
Data from the survey were mapped to the eight interventions identified in the TASYL transition theory highlighting where the data supports and refutes the theory and if new theoretical elements emerged
Summary
Managing transition of adolescents/young adults with life-limiting conditions from children’s to adult services has become a global health and social care issue. The Transition to Adult Services for Young Adults with Life-limiting conditions (TAYSL study) included development of the TASYL Transition Theory, which describes eight interventions which can help prepare services and adolescents/young adults with life-limiting conditions for a successful transition. We aimed to assess the usefulness of the TASYL Transition Theory in a Canadian context to identify interventions, mechanisms and contextual factors associated with a successful transition from children’s to adult services for adolescents/young adults; and to discover new theoretical elements that might modify the TASYL Theory. Transition from children’s to adult services has emerged in the last decade as a global health and social care issue. A poor transition to adult care may be associated with poor clinical outcomes, higher costs to both the health system and the family as well as low levels of patient and family satisfaction [7], an international cross-jurisdictional policy scoping review focusing on identifying health system strategies that support transition to adult care in nine countries, found that the United Kingdom and Australia were the only countries which demonstrated efforts to develop transition to adult service strategies [7]
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