Perceived transition self-efficacy and transition readiness among children and youth with special healthcare needs (CYSHCN) preparing to transition to adult healthcare from Texas Children\u27s Hospital

Background: Transition from pediatric healthcare to adult healthcare is a complex process especially for children with special healthcare needs. In order for them to be ready to transfer to adult healthcare they need to acquire a high level of self-efficacy in their ability to perform day-to-day healthcare related tasks. In the present study, we investigate how children with special healthcare needs perceived themselves as confident in their self-management skills and ready to transfer to adult healthcare. Objectives: We investigated the relationship between perceived transition self-efficacy and perceived transition readiness, and we explored factors associated with transition readiness from pediatric to adult healthcare among adolescents and young adults with special healthcare needs 16 to 25 years of age seen at Texas Children’s Hospital in Houston, Texas. Methods: In this study data from 42 patients’ questionnaires and electronic medical records database were analyzed. The data were collected from patients attending four clinics at Texas Children’s Hospital (Retrovirology, Cardiology, Sickle Cell Disease, and Physical Medicine and Rehabilitation clinics). Variables of interest included patients’ characteristics such as age, race, gender, level of income, insurance status, the service they received, the number of questions successfully accomplished in the electronic Transition Planning Template (TPT) designed by Texas Children’s Hospital to facilitate transition to adult healthcare, perceived self-efficacy, and perceived transition readiness. Results: Nineteen (45.2%) of the study participants perceived themselves to be ready to transfer to adult healthcare. Perceived readiness to transition was strongly associated with perceived self-efficacy in independent self-management skills (OR 1.2, 95% CI 1.03-1.31, p = 0.011), especially, in knowing the name of their adult doctors (r = 0.51, p = 0.001), explaining their medications (r = 0.41, p = 0.007), and providing their health insurance information (r = 0.33, p = 0.03). Although there was high correlation between high self-efficacy score and transition readiness to adult healthcare (r = 0.43, p = 0.004), there was no correlation between the number of questions successfully accomplished in the TPT and perceived transition readiness (r = 0.009, p = 1.0). Logistic regression revealed that age (OR 1.86, 95% CI 0.88-3.94) and other sociodemographic factors were not associated with perceived transition readiness. Conclusion: Perception of self-efficacy in independent self-management skills is a strong predictor of transition readiness among children and youth with special healthcare needs. Healthcare providers need to take the opportunity to assess children’s self-efficacy during their regular clinic visits and enhance their ability and their confidence in performing healthcare related tasks in order for them to have smooth transition to adult healthcare