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J Adv Nurs. 2015 Jun;71(6):1324-35. doi: 10.1111/jan.12617. Epub 2015 Jan 23.

Assessing readiness for transition from paediatric to adult health care: Revision and psychometric evaluation of the Am I ON TRAC for Adult Care questionnaire.

Author information

1
School of Nursing, University of British Columbia, Vancouver, British Columbia, Canada.
2
School of Nursing and Division of Adolescent Medicine, University of British Columbia, Vancouver, British Columbia, Canada.
3
Department of Paediatrics, Division of Adolescent Medicine, University of British Columbia, Vancouver, British Columbia, Canada.
4
Youth Transitions Initiative, BC Children's Hospital, Vancouver, British Columbia, Canada.
5
Division of Adolescent Health, BC Children's Hospital, Vancouver, British Columbia, Canada.

Abstract

AIM:

To refine and psychometrically test the Am I ON TRAC for Adult Care questionnaire.

BACKGROUND:

Inadequate transition to adult care for adolescents with special healthcare needs has been associated with greater risk of treatment non-adherence, lack of medical follow-up, increased morbidity and mortality. Presently, there are no well-validated measures assessing adolescents' readiness to transition from paediatric to adult medical care.

DESIGN:

Descriptive cross-sectional study.

METHODS:

The Am I ON TRAC for Adult Care questionnaire was refined to improve the instrument's methodological soundness. A literature review informed the revisions. A convenience sample of 200 adolescents, 12-19 years, was recruited from four outpatient clinics at a paediatric hospital in Western Canada between April-June 2012. Construct validity was evaluated by Exploratory Factory Analysis; concurrent validity was assessed using the Psychosocial Maturity Index. Internal consistency was evaluated by computing Cronbach's alpha estimates.

RESULTS:

Factor analysis of the knowledge items identified a 14-item unidimensional scale. Knowledge and behaviour sub-scale scores increased with age, with a stronger relationship between knowledge and age. Psychosocial maturity correlated with both sub-scale scores, but had a stronger association with behaviour. Psychosocial maturity and age had a weak but significant correlation suggesting age is a loose proxy for maturity. Only 27% of 17-year olds, but 62% 18-year olds, scored above the behaviour cut-off for transition readiness.

CONCLUSION:

The revised Am I ON TRAC for Adult Care questionnaire is a psychometrically sound measure that has potential to be used as a readiness assessment tool in both clinical practice and research.

KEYWORDS:

adolescent health; chronic illness; factor analysis; instrument development; psychosocial nursing

PMID:
25616006
PMCID:
PMC4690724
DOI:
10.1111/jan.12617
[Indexed for MEDLINE]
Free PMC Article

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