Understanding transition from paediatric to adult services in young people with gastrointestinal disorders

This thesis comprises a literature review and a research paper. The literature review explores the current evidence for the barriers and facilitators for a successful transition to adult services for young people with gastrointestinal disorders. Seventeen studies were identified. The findings suggest that the transition should be a flexible, gradual process that involves joint care between paediatric and adult services. The competencies of young people need to be assessed and developed to prepare them for adult care, with interventions also addressing parental involvement. The research study used a qualitative approach to explore the transition experiences of young people with coeliac disease (CD), from the perspective of both young people and their parents. Seven young people and six parents were interviewed. The data was analysed using Interpretative Phenomenological Analysis (IPA). Three super-ordinate themes were identified for each subgroup, which overlapped extensively: ‘Absence of discussion and abandonment’, ‘Understanding my coeliac disease and me’ and ‘Responsibility is an evolving process’. A lack of discussion and involvement in the transition was associated with feelings of abandonment and apprehension. Many participants felt their CD-knowledge and psychosocial needs were not sufficiently addressed. Assuming responsibility for the utilisation of services varied across participants, and parental involvement did not necessarily end with transfer to adult services