title: What is the perceived nature of parental care and support for young people with cystic fibrosis as they enter adult health services?
abstract: The majority of those diagnosed with cystic fibrosis (CF) now live to adulthood. In response to increased survival age, transition services have been developed to ensure smooth transfer from paediatric to adult specialist healthcare, although the majority of treatment and care continues to be delivered in the home. However, little is known about how young adults and staff conceptualise the nature of the parental role after young people have left paediatric care. The aim of this study is to explore the nature of parental support that is perceived to be available at this time. As part of a larger study of transitional care, semi-structured interviews were conducted with 50 young people with CF aged 13-24 years (32 with experience of transition and/or adult CF services) and 23 specialist healthcare professionals (14 working in adult care) across two CF centres in Southeast England. Interviews took place in young people's homes or within CF services, using a topic guide and were recorded, transcribed and analysed thematically. Four domains of perceived parental support were identified by the young people interviewed, with varying degrees of continuity into adult care: (1) Providing non-clinical practical and emotional support; (2) Acting as 'troubleshooters' in times of health-related crisis; (3) Working in partnership with offspring in ongoing disease management in the home and clinic; (4) Acting as 'protectors' of their children. Young people and service staff expressed tensions in managing parental involvement in post-paediatric consultations and the degree to which parents should be aware of their offspring's deteriorating health and social concerns. Parental anxiety and over-involvement was perceived by many young people and staff as unsupportive. We suggest that although health and social care providers are mindful of the tensions that arise for those leaving paediatric services, the place of parental support in adult care is currently contentious for these 'new' ageing populations.
authors.affiliation: Department of Respiratory Medicine, King's College London, London, UK.
authors.forename: Nicola
authors.initials: N
authors.lastname: Iles
authors.forename: Karen
authors.initials: K
authors.lastname: Lowton
mesh_terms: D000293:Adolescent; D000328:Adult; D032721:Adult Children / Q000523:psychology*; D001294:Attitude to Health; D017028:Caregivers / Q000523:psychology*; D003266:Continuity of Patient Care / Q000458:organization & administration; D003550:Cystic Fibrosis / Q000523:psychology* / Q000628:therapy*; D019468:Disease Management; D005260:Female; D006801:Humans; D008297:Male; D010290:Parents / Q000523:psychology*; D012944:Social Support; D012962:Sociology, Medical; D055815:Young Adult