Patient–caregiver dyad concordance of transition readiness assessment for adolescent with cancer: A network analysis

Abstract

AimsThe concordance of adolescents with cancer and caregivers was examined, and the core elements of transition readiness were identified.MethodsIn this cross‐sectional study, 196 adolescent–caregiver dyads completed the Chinese version of Self‐Management and Transition to Adulthood with Rx = Treatment Questionnaire and its parent version between March 2023 and August 2023. Intraclass correlation coefficients, paired t‐tests and network analysis were used for data analysis.ResultsCaregivers reported slightly lower scores for transition readiness than adolescents (3.28 vs. 3.32). Healthcare engagement and provider communication were core elements in transition readiness networks. At the dyad level, agreement between adolescents' and caregivers' transition readiness ranged from poor to fair (intraclass correlation coefficients 0.103–0.486), and a significant difference in structure was found between the two networks.ConclusionsCaregivers tended to underestimate adolescents' transition readiness. Attaining better concordance between adolescents and family caregivers is critical to aligning roles and responsibilities in the transition process.Implications for Paediatric Cancer CareThis study extends the evidence on the variation in adolescents' transition readiness, clarifying the complex associative relationships among the elements of transition readiness, which can be potential pathways for improving transition readiness. Second, this study is the first to assess transition readiness from a dyad's perspective. The findings highlighted the patient–caregiver incongruence in rating patients' transition readiness, suggesting that targeted dyadic interventions should be developed and implemented to improve patient–caregiver transition readiness concordance, facilitate effective communication and mutuality between patients and caregivers, and contribute to their collaboration during the transition of adolescents and optimization of outcomes.What problem did the study address? Increased long‐term survival rates of survivors of paediatric cancer highlighted the significant need for care continuity. Transitional readiness is an important predictor of adolescent survivor's ability to adapt to a long‐term survival period. Assessments of adolescents' transition readiness are limited and overlook the synergies between family caregivers and adolescents in the transition period. What Were the Main Findings? The levels of agreement on rating transition readiness varied from poor to fair among adolescent–caregiver dyads, and caregivers tended to underestimate adolescents' transition readiness. The findings highlighted the patient–caregiver incongruence in rating patients' transition readiness. Targeted dyadic interventions should be developed and implemented to improve patient–caregiver's transition readiness concordance, and facilitate effective communication and mutuality between patients and caregivers. Reporting MethodStudy methods and results reported in adherence to the STROBE checklist.Patient or Public ContributionNo patients or members of the public were involved in the study.Contribution to the Wider Global Clinical CommunityThe main findings introduce pathways for improving transition readiness, which can enhance healthcare transition among other medical populations.