Top

06-09-2024 | Original Article

Modification and scoring of a transition tool to understand transition readiness among pediatric kidney transplant recipients

Authors: Caitlin Peterson, Leandra Bitterfeld

Abstract

Background

A successful transition from pediatric to adult healthcare for adolescent and young adult kidney transplant recipients is essential for maintaining graft and overall health. Readiness for transition is multifactorial and can be challenging to assess. The purpose of this study is to describe the development of a scoring system for a transition readiness assessment for pediatric kidney transplant recipients and assess overall and domain-specific readiness for transition.

Methods

This is an observational study of adolescent and young adult kidney transplant recipients over 5 years who were given either the modified Middle (MTRC-m) or modified Late Transition Readiness Checklist (LTRC-m) during post-transplant clinic visits. We developed a scoring system for both checklists and assessed their reliability.

Results

The MTRC-m (38 items) demonstrated good reliability (Cronbach’s α = 0.84). The LTRC-m (43 items) demonstrated excellent reliability (Cronbach’s α = 0.90). On both the MTRC-m and LTRC-m, patients scored highest on adherence and risky behavior knowledge. Scores were lowest in the “Managing my healthcare needs (self-advocacy)” and “How I feel about myself” domains.

Conclusions

A scored transition assessment allows for rapid appraisal of transition readiness within a clinic setting. We find that participants report high levels of knowledge regarding health-seeking behaviors and risky behaviors, endorse less readiness for managing their care independently, and express a moderate to high degree of worry about their future and their health. While transition programs have traditionally, and necessarily, focused on education, our results demonstrate that programs should expand to also focus on behavior performance and emotional well-being.

Graphical abstract

Available only for authorised users

Got Transition (2024) Six core elements of healthcare transition. https://www.gottransition.org/six-core-elements/. Accessed 10 Apr 2024

US Department of Health and Human Services (n.d.) Increase the proportion of adolescents who get support for their transition to adult health care — AH‑R01. https://health.gov/healthypeople/objectives-and-data/browse-objectives/adolescents/increase-proportion-adolescents-who-get-support-their-transition-adult-health-care-ah-r01. Accessed 9 Apr 2024

Spivey CA, Chisholm-Burns MA, Damadzadeh B, Billheimer D (2014) Determining the effect of immunosuppressant adherence on graft failure risk among renal transplant recipients. Clin Transplant 28:96–104. https://doi.org/10.1111/ctr.12283CrossRefPubMed

Annunziato RA, Parbhakar M, Kapoor K, Matloff R, Casey N, Benchimol C, Hotchkiss H, Nair V, Saland J (2015) Can transition to adult care for transplant recipients be improved by intensified services while patients are still in pediatrics? Prog Transplant 25:236–242. https://doi.org/10.7182/pit2015599CrossRefPubMed

Grady KL, Andrei AC, Shankel T et al (2019) Pediatric heart transplantation: transitioning to adult care (TRANSIT): feasibility of a pilot randomized controlled trial. J Card Fail 25:948–958. https://doi.org/10.1016/j.cardfail.2019.06.011CrossRefPubMedPubMedCentral

Fredericks EM, Magee JC, Eder SJ et al (2015) Quality improvement targeting adherence during the transition from a pediatric to adult liver transplant clinic. J Clin Psychol Med Settings 22:150–159. https://doi.org/10.1007/s10880-015-9427-6CrossRefPubMedPubMedCentral

Anton CM, Anton K, Butts RJ (2019) Preparing for transition: the effects of a structured transition program on adolescent heart transplant patients’ adherence and transplant knowledge. Pediatr Transplant 23:e13544. https://doi.org/10.1111/petr.13544CrossRefPubMed

American Society of Transplantation (2024) Pediatric Transition Portal. https://www.myast.org/education/specialty-resources/peds-transition. Accessed 10 April 2024

Tavakol M, Dennick R (2011) Making sense of Cronbach’s alpha. Int J Med Educ 2:53–55. https://doi.org/10.5116/ijme.4dfb.8dfdCrossRefPubMedPubMedCentral

10.

Centers for Disease Control and Prevention. Youth risk behavior survey data summary and trends report: 2011–2021. Updated June 14, 2024. https://www.cdc.gov/yrbs/dstr/index.html. Accessed 01 Jul 2024

11.

Hall KS, McDermott Sales J, Komro KA, Santelli J (2016) The state of sex education in the United States. J Adolesc Health 58:595–597. https://doi.org/10.1016/j.jadohealth.2016.03.032CrossRefPubMedPubMedCentral

12.

Simon L, Daneback K (2013) Adolescents’ use of the Internet for sex education: a thematic and critical review of the literature. Int J Sex Health 25:305–319. https://doi.org/10.1080/19317611.2013.823899CrossRef

13.

Bush R, Upadhyay K, McPeters S (2022) Identification of anxiety and depression among adolescent kidney transplant recipients: a cross-sectional observational study. J Pediatr Health Care 36:270–276. https://doi.org/10.1016/j.pedhc.2021.10.007CrossRefPubMed

14.

Wu YP, Aylward BS, Steele RG (2010) Associations between internalizing symptoms and trajectories of medication adherence among pediatric renal and liver transplant recipients. J Pediatr Psychol 35:1016–1027. https://doi.org/10.1093/jpepsy/jsq014CrossRefPubMed

15.

Arbel R, Perrone L, Margolin G (2018) Adolescents’ daily worries and risky behaviors: the buffering role of support seeking. J Clin Child Adolesc Psychol 47:900–911. https://doi.org/10.1080/15374416.2016.1169536CrossRefPubMed

16.

Soleimani MA, Pahlevan Sharif S, Bahrami N, Yaghoobzadeh A, Allen KA, Mohammadi S (2017) The relationship between anxiety, depression and risk behaviors in adolescents. Int J Adolesc Med Health 31:2. https://doi.org/10.1515/ijamh-2016-0148CrossRef

17.

Walker RC, Naicker D, Kara T, Palmer SC (2019) Children’s experiences and expectations of kidney transplantation: a qualitative interview study. Nephrology 24:647–653. https://doi.org/10.1111/nep.13405CrossRefPubMed

18.

Hind T, Lui S, Moon E et al (2021) Post-traumatic stress as a determinant of quality of life in pediatric solid-organ transplant recipients. Pediatr Transplant 25:e14005. https://doi.org/10.1111/petr.14005CrossRefPubMed

19.

Wildes DM, Costigan CS, Kinlough M et al (2023) Transitional care models in adolescent kidney transplant recipients-a systematic review. Nephrol Dial Transplant 38:49–55. https://doi.org/10.1093/ndt/gfac175CrossRefPubMed

Title: Modification and scoring of a transition tool to understand transition readiness among pediatric kidney transplant recipients
Authors: Caitlin Peterson
Leandra Bitterfeld
Publication date: 06-09-2024
Publisher: Springer Berlin Heidelberg
Published in: Pediatric Nephrology
Print ISSN: 0931-041X
Electronic ISSN: 1432-198X
DOI: https://doi.org/10.1007/s00467-024-06497-0

Keynote webinar | Spotlight on modern management of frailty

Springer Medicine

Modification and scoring of a transition tool to understand transition readiness among pediatric kidney transplant recipients

Abstract

Background

Methods

Results

Conclusions

Graphical abstract

Keynote webinar | Spotlight on modern management of frailty

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

Graphical abstract

Please log in to get access to this content