Readiness for Transition From Pediatric Sickle Cell Care: Exploratory Analyses of Domains of Readiness and Total Scores

In just one generation, the average survival of patients with sickle cell anemia has increased from 14 years to nearly 50 years, necessitating transition programs from pediatric to adult care. We developed a transition program to provide continuity of care from pediatric to adult settings. In order to provide education and skills via an individualized plan for transition of care, we assessed confidence/self-efficacy, knowledge, skills, and attitudes surrounding transition of 34 African-American individuals aged 15–21 (mean 17). We hypothesized that there would be correlation between each of these domains, and that such correlation would suggest that each domain predicts initial readiness/sophistication for transition.

We administered a survey battery both of items we constructed and of previously used survey items assessing medical, Educational/Vocational, Health Benefits, Social, Independent Living, Feelings, Sickle Cell Stress, and Self-Efficacy domains. We assigned/mapped these content items, using clinical judgment and consensus, to four domains of “readiness for transition”: confidence/self-efficacy, knowledge, skills, and attitudes. Readiness scores for each domain were calculated such that a summary score of 100 would indicate perfect readiness in each domain. The complete question battery is available.

Results are shown in the table below.

Attitudinal readiness, knowledge readiness, confidence readiness, and skill readiness for transition were low initially in sickle cell adolescents enrolled in a transition program. Percentage of maximum possible scores was lowest for attitude, and highest for skill. Both attitude and knowledge scores showed very high correlation with total readiness score. However, several component scores were moderately correlated with each other. Transition programs for SCD should consider assessing and enhancing not only knowledge, but also attitudes, confidence, and skill.

No relevant conflicts of interest to declare.