Psychologists’ perception of adolescents with serious illnesses and their transition to the adult healthcare system

Abstract

Background: Psychologists play a key role in the organization of care and the trajectory of patients in pediatrics, especially in how well young patients with chronic or degenerative illnesses fare through the transition to the adult sector. Their perception of the transition period and current practice have never been systematically researched yet. The aim of this study is to describe pediatric psychologists’ perceived facilitators and barriers to the transition period and review their professional practices. Methods: We led a qualitative research inquiry with 10 pediatric psychologists working at Sainte-Justine UHC (Montréal, Qc, Canada). Participants took part in an one-hour individual semi-structured interview. Inductive thematic analysis of verbal transcripts was used to describe participants perceptions of the transition process, and identify facilitators and barriers of an adequate transition within their practice. Findings Psychologists conceptualized transitioning according to three general themes: the concept itself, specific characteristics, and temporal markers. Perceived facilitators included long-term follow-up, professional autonomy and therapeutic alliance. Perceived barriers included hasty transition, adult services’ accessibility and patients’ resistance to change. Professionals recommended having a specific support transition unit and, most importantly, a consultant role in their own team in order to improve the transition process within their own practice and the organization of care. Discussion: The results bear important practical implications for optimizing the transition process, including assessing transition readiness early, dedicating more time to teamwork and case discussions within the team, and fostering relationships with the future adult heath care facility.