title: Transition of young people with chronic conditions: a cross-sectional study of patient perceptions before and after transfer from pediatric to adult health care.
abstract: The aim of this study was to compare perceived barriers to and the most preferred age for successful transition to adult health care between young people with chronic disorders who had not yet transferred from pediatric to adult health care (pre-transfer) and those who had already transferred (post-transfer). In a cross-sectional study, we compared 283 pre-transfer with 89 post-transfer young people, using a 28-item questionnaire that focused on perceived barriers to transition and beliefs about the most preferred age to transfer. Feeling at ease with the pediatrician was the most important barrier to successful transition in both groups, but was rated significantly higher in the pre-transfer compared to the post-transfer group (OR = 2.03, 95 %CI 1.12-3.71). Anxiety and lack of information were the next most important barriers, rated equally highly by the two groups (OR = 0.67, 95 %CI 0.35-1.28 and OR = 0.71, 95 %CI 0.36-1.38, respectively). More than 80 % of the respondents in both groups reported that 16-19 years was the most preferred age to transfer; more than half of all the respondents reported 18-19 years and older as the most preferred age.
  
  
  CONCLUSIONS
  Better transition planning through the provision of regular and more detailed information about adult health-care providers and the transition process could reduce anxiety and contribute to a more positive attitude to overcome perceived barriers to transition from young people's perspective. Young people's preferences about transferring to adult health care provide a challenge to those children's hospitals that transfer to adult health care at a younger age.
authors.affiliation: Head Adolescent Medicine Unit, University Children's Hospital, Steinwiesstrasse 75, 8032, Zurich, Switzerland, christoph.rutishauser@kispi.uzh.ch.
authors.forename: Christoph
authors.initials: C
authors.lastname: Rutishauser
authors.forename: Susan M
authors.initials: SM
authors.lastname: Sawyer
authors.forename: Anne-Emmanuelle
authors.initials: AE
authors.lastname: Ambresin
mesh_terms: D000293:Adolescent; D000328:Adult; D002908:Chronic Disease; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D010361:Patients / Q000523:psychology*; D010817:Physician-Patient Relations; D011795:Surveys and Questionnaires; D060305:Transition to Adult Care; D055815:Young Adult