The roles of quality of life and family and peer support in feelings about transition to adult care in adolescents with gastroenterology, renal, and rheumatology diseases

• Published in: Journal of pediatric nursing 2022-01, Vol.62, p.193-199
• Main Authors: Zimmerman, CortneyT, Garland, Beth H., Enzler, Cassandra J., Hergenroeder, Albert C., Wiemann, Constance M.
• Format: Article
• Language: English
• Subjects: Acceptance and Commitment Therapy; Adolescent; Adult; Child; Emotions; Family support; Gastroenterology; Health care transition; HRQOL; Humans; Peer support; Quality of Life; Rheumatology; Surveys and Questionnaires; Transition to Adult Care
• ISSN: 0882-5963; 1532-8449
• DOI: 10.1016/j.pedn.2021.04.032

Transition to adult healthcare is a critical time in the lives of adolescents with chronic medical conditions, with clear impacts on health outcomes. Little is known about factors that impact feelings about healthcare transition, including HRQOL, family and peer support, and utilization of a framework such as the SMART Model can guide exploration of these factors. The goal of this study is to examine how HRQOL (i.e., functional impact of disease) and family and peer support may impact adolescents' feelings about healthcare transition. 135 adolescents (17–23 years) with chronic gastroenterology, renal, or rheumatology disease completed four questionnaires as part of a larger study examining health, relationships, and healthcare transition. Questions assessed current HRQOL (i.e., number of days health was “not good”), peer and family support, and feelings about transition. Data were analyzed using SPSSv25 and linear regressions were performed. Lower HRQOL (β = 0.283, p < .01) and less peer support (β = −0.198, p < .05) were associated with worse feelings about transition (R2 = 0.203, p < .001). Family support was significantly correlated at the bivariate level. There were no differences by type of disease, race/ethnicity, or gender that impacted study findings. Results are concerning as healthcare transition is a milestone for every patient. Lower HRQOL (i.e., greater functional impact of disease) and less peer support were associated with worse feelings about transition. This study highlights potential targets for intervention such as improving HRQOL (e.g., acceptance and commitment therapy) and increasing peer support (e.g., social skills training, family facilitation) to improve transition to adult care for pediatric patients with chronic diseases. •Better quality of life was associated with better feelings about healthcare transition.•Peer support was associated with better feelings about healthcare transition.•Family support was correlated with feelings about healthcare transition.•Interventions such as psychological treatment could improve quality of life.•Connecting with support groups or peer mentors may improve peer support.