Assessment of transition readiness in adolescents in Thailand with rheumatic diseases: a cross-sectional study

Abstract

Background Most childhood-onset rheumatic diseases are chronic health conditions, which need long-term care throughout adulthood. A well-organized transition care is challenging and patient assessment of transition skills is needed for transfer preparation to an adult care setting. The Transition Readiness Assessment Questionnaire (TRAQ) is used to assess transition skills in chronically ill patients. Currently, limited transition skill assessment data exist in pediatric patients with rheumatic diseases, especially in Asian countries. This study aimed to determine the transition readiness skills in patients with rheumatic diseases and ascertain predictive factors contributing to high transition readiness skills. Methods This is a cross-sectional study. All patients with rheumatic diseases aged 15–20 years were recruited. The TRAQ was cross-culturally adapted into the Thai language with good internal consistency and reliability. Patients completed the Thai TRAQ at the recent clinic visit and took the retest at a 2-week interval. Demographic data, baseline characteristics, clinical manifestations, and disease status were collected. Descriptive and logistic regression analyses were performed. Results A total of 111 patients with a mean age of 17.4 ± 1.8 years were included. Median (IQR) disease duration was 6.4 (3.2–9.0) years. The most common rheumatic disease was juvenile idiopathic arthritis (48.6%), followed by systemic lupus erythematosus (35.1%). The mean TRAQ score was 3.85 ± 0.69. Independent visits (OR 4.35, 95% CI 1.23–15.37) was a predictor of a high TRAQ score. Furthermore, dependent visits (OR 7.84, 95% CI 2.41–25.50) was a predictor of low TRAQ score in the “appointment keeping” domain, whereas inactive disease (OR 4.54, 95% CI 1.25–16.55) was a predictor of a low TRAQ score in “tracking health issues” domain. Lack of knowledge and skills on health insurance coverage, financial management, appointment arrangement, and coping with their illness were issues causing lower TRAQ score. Conclusions Patients, who had independent visits, had a higher chance to obtain higher TRAQ scores, whereas patients, who had an inactive disease or dependent visits, had less transition readiness skills. Physicians and parents should prepare to transfer patients to adult care settings, mainly encouraging independent living skills.

Hungarian Linguistic, Cross-Cultural and Age Adaptation of Transition Specific Questionnaires in Patients with Inflammatory Bowel Disease

“…The older the participants were, the higher the total score and subscore for domains self-management were achieved. The mean total score, which highlights important shortcomings of education and transition readiness, was in line with the scores of other adaptations [ 43 , 44 ].…”

“…Thus, domains 3, 4, and 5 should not be used separately for comparison, only as a whole. The internal consistency values of the overall, and domains 1, 2, and 5, showed almost the same Cronbach’s α coefficient as in the original [ 28 ], and the overall internal consistency results were almost identical to the results of the adapted versions [ 43 , 44 , 45 , 46 ]. Internal consistency values for test–retest reliability remained below the acceptable threshold, and our result was lower than in other studies [ 43 , 45 ].…”

“…The internal consistency values of the overall, and domains 1, 2, and 5, showed almost the same Cronbach’s α coefficient as in the original [ 28 ], and the overall internal consistency results were almost identical to the results of the adapted versions [ 43 , 44 , 45 , 46 ]. Internal consistency values for test–retest reliability remained below the acceptable threshold, and our result was lower than in other studies [ 43 , 45 ]. Despite the TRAQ’s high ranking of quality and utility, Carlsen et al have also revealed that the questionnaire may not be developmentally appropriate for adolescents under 20 years [ 35 , 47 ].…”

“…The TRAQ survey was validated for adolescents with cystic fibrosis in the United States [ 28 ]. The questionnaire was used internationally, e.g., USA, England, Canada, and Italy, [ 28 , 36 , 37 , 38 , 39 , 40 , 41 , 42 ] and adapted for other chronic conditions, but an adaptation of IBD is still missing [ 11 , 43 , 44 , 45 , 46 ]. Adapted versions are available in Spanish for patients diagnosed with various chronic diseases, in Thai, and Brazilian-Portuguese for rheumatologic disorders, for the American pediatric population with epilepsy, and in Turkish for adolescents with diabetes [ 11 , 43 , 44 , 45 , 46 ].…”

Transition readiness in adolescents with juvenile idiopathic arthritis and their parents: Our single-center experience

“…[9][10][11][12][13][14][15][16] To avoid the occurrence of permanent disability, it is important to adequately educate and provide psycho-emotional support to JIA patients and their parents as early as possible by implementing the Six Core Elements of Healthcare Transition, including the assessment of transition readiness. 17 Therefore, it is necessary to assess the readiness of young patients with JIA to accept the transition from pediatric to adult rheumatologist using certain transition readiness tools, including the Transition Readiness Assessment Questionnaire (TRAQ). [18][19][20] The TRAQ is a validated 20-item questionnaire, which assesses the patient's disease self-management and healthcare skills.…”