Self-efficacy and readiness for transition from pediatric to adult care in sickle cell disease

Abstract

The TIP-RFT assessment, along with measures of self-efficacy and stress, appear to be useful measures of overall transition readiness for youth and young adults with SCD. Future studies should evaluate whether self-management skill development and health outcomes are indeed affected by programs to improve readiness for transition from pediatric to adult care.

Development of quality indicators for transition from pediatric to adult care in sickle cell disease: A modified Delphi survey of adult providers

“…Self‐efficacy in disease management and the closely related constructs of adherence to clinic visits and medications were the highest rated patient factors for successful transition. Self‐efficacy and adherence are also included in the assessments of transition readiness, both in SCD and in nondisease‐specific studies . Better self‐efficacy has been associated with improved transition in SCD …”

“…Several of the metrics with the highest importance ratings in our survey were not considered highly feasible to measure, specifically adherence to treatment and medication, good self‐efficacy, quality of life, and trust in an adult provider. There are validated measures for quality of life and self‐efficacy as well as trust in a physician, with disease‐specific measures of quality of life and self‐efficacy; however, like many questionnaires, these may not be practicable for routine use in clinical practice . The lower ratings of feasibility are likely related to not having work‐flow set up to measure and track metrics such as medication adherence, which are not as straightforward to measure as adherence to clinic visits .…”

“…We created a list of candidate quality indicators for the transition from pediatric to adult care in SCD based on the literature, clinical experience, and our prior work. Transition process measures included meeting an adult provider before transfer, an appropriate interval between last pediatric visit and first adult clinic visit, transition counseling, and transition planning . Patient measures included transition readiness and SCD‐specific knowledge .…”

“…Transition process measures included meeting an adult provider before transfer, an appropriate interval between last pediatric visit and first adult clinic visit, transition counseling, and transition planning. 13,15,[23][24][25] Patient measures included transition readiness and SCD-specific knowledge. 26 We included outcome measures such as ED utilization, hospitalization rates, and mortality after leaving pediatric care, which have been suggested as markers of transition quality.…”

“…Self-efficacy and adherence are also included in the assessments of transition readiness, both in SCD and in nondisease-specific studies. 25,26,36 Better self-efficacy has been associated with improved transition in SCD. 24 Currently, many transition programs and readiness assessment tools focus on disease-specific knowledge rather than selfefficacy.…”