Implementation of a Transition-Readiness Questionnaire with Survivors of Childhood Cancers in Hawaiʻi
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2021
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University of Hawaii at Manoa
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Childhood cancer survivors face multiple barriers in transitioning from the care of their pediatric oncologist to adult oriented survivorship care, thus they may remain in pediatric care for prolonged periods. Once they transition, they may fail to maintain the long-term follow-up care that is designed to reduce potential chronic health problems stemming from their treatments. This quality improvement project aimed to improve patient transition from pediatric oncology care to adult survivorship care at a single facility in Hawaiʻi by piloting a transition-readiness assessment. The TRANSITION-Q, a 14-item questionnaire validated to measure readiness for transition of care, was administered to adolescent and young adult (AYA) patients who remained under the care of their pediatric oncologists (n=8), and who had transferred to adult survivorship care (n=30). Areas to improve transition-readiness were identified using chi-square analysis of the responses. Education sessions on transition-readiness questionnaire results and recommended interventions were delivered to providers. Mean TRANSITION-Q scores for the two patient groups were 71.4 and 80.6 respectively (p=0.047). Analysis showed significant differences for two TRANSITION-Q items: "I speak to the doctor instead of my parent(s) speaking for me," (p=0.049), and "I contact a doctor when I need to" (p=0.034). Other intervention opportunities were identified by TRANSITION-Q items to which patients most frequently responded "never" or "sometimes." Providers' ratings of the acceptability and feasibility of the implementation increased over the implementation period. The continued administration of the TRANSITION-Q and its inclusion in the EHR are recommended. An intervention focused on improving AYA patient-initiated communication could increase transition readiness.
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Oncology
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