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, 71 (6), 1324-35

Assessing Readiness for Transition From Paediatric to Adult Health Care: Revision and Psychometric Evaluation of the Am I ON TRAC for Adult Care Questionnaire

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Assessing Readiness for Transition From Paediatric to Adult Health Care: Revision and Psychometric Evaluation of the Am I ON TRAC for Adult Care Questionnaire

Melissa Moynihan et al. J Adv Nurs.

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.

Conflict of interest statement

Conflict of Interest Statement: The authors have no conflicts of interest to declare.

Figures

Figure 1
Figure 1
Mean ON TRAC Knowledge Scores by Age
Figure 2
Figure 2
Mean ON TRAC Knowledge Scores by ON TRAC Stage
Figure 3
Figure 3
Percentage of Youth that Met the Behaviour Index Cut-off Score Grouped by Age

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