title: Transition from pediatric to adult health care: expectations of adolescents with chronic disorders and their parents.
abstract: The aim of this study was to assess the expectations of adolescents with chronic disorders with regard to transition from pediatric to adult health care and to compare them with the expectations of their parents. A cross-sectional study was carried out including 283 adolescents with chronic disorders, aged 14-25 years (median age, 16.0 years), and not yet transferred to adult health care, and their 318 parents from two university children's hospitals. The majority of adolescents and parents (64%/70%) perceived the ages of 18-19 years and older as the best time to transfer to adult health care. Chronological age and feeling too old to see a pediatrician were reported as the most important decision factors for the transfer while the severity of the disease was not considered important. The most relevant barriers were feeling at ease with the pediatrician (45%/38%), anxiety (20%/24%), and lack of information about the adult specialist and health care (18%/27%). Of the 51% of adolescents with whom the pediatric specialist had spoken about the transfer, 53% of adolescents and 69% of parents preferred a joint transfer meeting with the pediatric and adult specialist, and 24% of these adolescents declared that their health professional had offered this option. In summary, the age preference for adolescents with chronic disorders and their parents to transfer to adult health care was higher than the upper age limits for admission to pediatric health care in many European countries. Anxiety and a lack of information of both adolescents and their parents were among the most important barriers for a smooth and timely transfer according to adolescents and parents.
authors.affiliation: Adolescent Medicine Unit, University Children's Hospital Zurich, Zurich, Switzerland. christoph.rutishauser@kispi.uzh.ch
authors.forename: Christoph
authors.initials: C
authors.lastname: Rutishauser
authors.forename: Christina
authors.initials: C
authors.lastname: Akré
authors.forename: Joan-Carles
authors.initials: JC
authors.lastname: Surìs
mesh_terms: D000293:Adolescent; D016497:Adolescent Health Services; D000328:Adult; D000367:Age Factors; D001294:Attitude to Health; D002908:Chronic Disease / Q000523:psychology / Q000628:therapy*; D003430:Cross-Sectional Studies; D005260:Female; D019538:Health Care Surveys; D006801:Humans; D008297:Male; D010290:Parents; D010372:Pediatrics; D012017:Referral and Consultation; D011795:Surveys and Questionnaires; D013557:Switzerland; D055815:Young Adult