305 - “Examining only medical related behaviours, places transition readiness in a vacuum, which is unrealistic”: a qualitative exploration of transition readiness behaviours

Publication Number: 305.3636

Megan Patton, University of Calgary, Calgary, AB, Canada; Zoya Punjwani, University of Calgary, Calgary, AB, Canada; Susan M. Samuel, University of British Columbia Faculty of Medicine, Vancouver, BC, Canada; Gina Dimitropoulos, University of Calgary-Faculty of Social Work, Calgary, AB, Canada

Background: The transition from pediatric to adult care can be challenging for young adults with chronic health conditions and can contribute to adverse outcomes and lack of continuity of care. Individualized transition support can be guided by readiness assessments, such as the Transition Readiness Assessment Questionnaire (TRAQ). Practice guidelines for transition success recommend the use of structured transition supports, such as a patient navigator (PN). While the wide-reaching benefits of PN are well cited within the literature such as improving health care access, increasing adherence to care, and empowering patients to advocate for their needs, research to date has not yet determined whether the help seeking behaviours PNs are observing align with what is being measured in readiness assessments.

Objective: Describe the transition behaviours of participants being reported/documented by a patient navigator in notes from a clinical trial (in the group assigned to the navigator intervention).

Design/Methods: This study employed a patient-oriented, qualitative descriptive methodology to examine what transition behaviours were observed and reported in clinical case notes by the PN in a clinical trial. We employed a thematic analytic approach to extrapolate observed transition behaviours as recorded in PN notes from encounters at baseline, 12 and 24 months.

Results: A total of 362 PN notes were included. Thematic analysis revealed four overarching themes related to transition readiness: 1) self-management, 2) self-advocacy, 3) mental health, and, 4) social supports. Within the PN notes, it appeared as though the navigator was providing substantial mental health support and education, which is an area not captured by the TRAQ. The notes fit under managing co-occurring physical and mental health conditions, suicidality/self-harm, mental health supports, and drugs and substance use. Many AYA appeared to experience difficulties related to their mental health during their transition.

Conclusion(s): This research sought to explore the transition behaviours of participants as reported by a PN and how the behaviours aligned or not with those measured in the TRAQ. We found that the domains in the TRAQ were behaviours observed by the PNs, however, there were a range of behaviours not being measured by TRAQ. The results demonstrate that the transition experience is much more than just questions and points on a checklist. AYA need guidance and support in areas beyond self-management and self-advocacy.