title: Health care providers' attitudes towards transfer and transition in young persons with long term illness- a web-based survey.
abstract: Transition programs in health care for young persons with special health care needs aim to maximize lifelong functioning. Exploring health care professionals' perspective may increase the possibility of successful implementation of transition programs. The aim was to survey health care professionals' attitudes towards components and barriers on transition and transfer in young people with long-term medical conditions with special health care needs.
  
  
  
  A cross-sectional web-based survey was sent by e-mail to 529 physicians and nurses in Swedish pediatric and adult outpatient clinics. Response rate was 38% (n = 201). The survey consisted of 59 questions regarding different aspects of components and barriers on transition and transfer. Descriptive statistics were computed to summarize demographic data and categorized responses. The Chi square test was used for comparison between proportions of categories.
  
  
  
  Most respondents agreed on the destinations of care for adolescents within their specialty. Age and psychosocial aspects such as maturity and family situations were considered the most important initiators for transfer. Joint meeting with the patient (82%); presence of a transition coordinator (76%) and a written individualized transfer plan (55%) were reported as important transition components. Pediatric care professionals found the absence of a transition coordinator to be more of a transition barrier than adult care professionals (p = 0.018) and also a more important transfer component (p = 0.017). Other barriers were lack of funding (45%) and limited clinical space (19%). Transition programs were more common in university hospitals than in regional hospitals (12% vs 2%, p = <0.001) as well as having a transition coordinator (12% vs 3%, p = 0.004).
  
  
  
  The findings highlight a willingness to work on new transition strategies and provide direction for improvement, taking local transition components as well as potential barriers into consideration when implementing future transition programs. Some differences in attitudes towards transitional care remain among pediatric and adult care professionals.
authors.affiliation: Institute of Health and Care Sciences, The Sahlgrenska Academy, University of Gothenburg, Box 457, SE- 405 30, Gothenburg, Sweden. carina.s-lundin@fhs.gu.se.
authors.forename: Carina
authors.initials: C
authors.lastname: Sparud-Lundin
authors.affiliation: Department of Health Science, University West, SE-461 32, Trollhättan, Sweden.|Centre for Person-Centred Care (GPCC), University of Gothenburg, Box 457, SE- 405 30, Gothenburg, Sweden.
authors.forename: Malin
authors.initials: M
authors.lastname: Berghammer
authors.affiliation: Institute of Health and Care Sciences, The Sahlgrenska Academy, University of Gothenburg, Box 457, SE- 405 30, Gothenburg, Sweden.|KU Leuven Department of Public Health and Primary Care, Kapucijnenvoer 35, Box 7001, BE-3000, Leuven, Belgium.
authors.forename: Philip
authors.initials: P
authors.lastname: Moons
authors.affiliation: Institute of Health and Care Sciences, The Sahlgrenska Academy, University of Gothenburg, Box 457, SE- 405 30, Gothenburg, Sweden.|Department of Pediatric Cardiology, The Queen Silvia Children's Hospital, SE-416 85, Gothenburg, Sweden.
authors.forename: Ewa-Lena
authors.initials: EL
authors.lastname: Bratt
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000553:Ambulatory Care; D001291:Attitude of Health Personnel; D002648:Child; D002908:Chronic Disease / Q000628:therapy*; D003142:Communication; D003430:Cross-Sectional Studies; D034742:Electronic Mail; D005260:Female; D006801:Humans; D020407:Internet; D008134:Long-Term Care; D008297:Male; D008875:Middle Aged; D009726:Nurses / Q000523:psychology*; D010360:Patient Transfer; D010820:Physicians / Q000523:psychology*; D011795:Surveys and Questionnaires; D013548:Sweden; D060305:Transition to Adult Care; D055815:Young Adult
keywords: Attitudes; Chronic illness; Health care professionals; Transition; Young persons