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

Authors

  • Melissa Moynihan MSN RN,

    Corresponding author
    1. School of Nursing, University of British Columbia, Vancouver, British Columbia, Canada
    Search for more papers by this author
  • Elizabeth Saewyc PhD RN FSAHM FCAHS,

    Professor
    1. School of Nursing and Division of Adolescent Medicine, University of British Columbia, Vancouver, British Columbia, Canada
    Search for more papers by this author
  • Sandra Whitehouse MD FRCPC MALS,

    Clinical Associate Professor/Medical Lead
    1. Department of Paediatrics, Division of Adolescent Medicine, University of British Columbia, Vancouver, British Columbia, Canada
    2. Youth Transitions Initiative, BC Children's Hospital, Vancouver, British Columbia, Canada
    Search for more papers by this author
  • Mary Paone MSN RN,

    Nursing Lead for Transition
    1. Division of Adolescent Health, BC Children's Hospital, Vancouver, British Columbia, Canada
    Search for more papers by this author
  • Gladys McPherson PhD RN

    Associate Professor
    1. School of Nursing, University of British Columbia, Vancouver, British Columbia, Canada
    Search for more papers by this author

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.

Ancillary