Assessing allocation of responsibility for health management in pediatric liver transplant recipients

Given the increased risk for non‐adherence and poor health outcomes in late adolescence, there is a need for better methods to evaluate and improve the transition process as adolescent patients are prepared to be independent adults. This study assessed the psychometrics and concurrent validity of a...

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Published inPediatric transplantation Vol. 19; no. 5; pp. 538 - 546
Main Authors Bilhartz, Jacob L., Lopez, M. James, Magee, John C., Shieck, Victoria L., Eder, Sally J., Fredericks, Emily M.
Format Journal Article
LanguageEnglish
Published Denmark Blackwell Publishing Ltd 01.08.2015
Subjects
Adolescent
Child
Communication
Female
Humans
Immunosuppressive Agents - therapeutic use
Liver Transplantation
Male
Patient Compliance
pediatrics
Professional-Patient Relations
Psychometrics
Quality Improvement
Self Care
Surveys and Questionnaires
Transition to Adult Care
Transplant Recipients
Treatment Outcome
adolescent
transition to adult care
liver transplantation
self-care
pediatrics
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Summary:Given the increased risk for non‐adherence and poor health outcomes in late adolescence, there is a need for better methods to evaluate and improve the transition process as adolescent patients are prepared to be independent adults. This study assessed the psychometrics and concurrent validity of a newly developed measure of AoR for health management in pediatric liver transplant patients. A total of 48 patients and 37 parents completed a 13‐item measure of AoR. We performed an exploratory PCA on survey results and used component scores to assess the relationship between AoR and age, age at transplant, adherence, and health outcomes. Two primary components were identified: communication with the healthcare system and self‐management tasks. Parent perception of adolescent responsibility for tasks related to communicating with the healthcare system was correlated, in younger patients, with increased non‐adherence while responsibility for tasks related to self‐management was correlated, in older patients, with decreased non‐adherence. These results support AoR as a two‐domain construct, and they provide targets for monitoring and intervention as adolescent patients advance toward transfer.
Bibliography:NIH - No. K23DK090202
ArticleID:PETR12466
Charles Woodson Biostatistics Fund - No. G010598
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ark:/67375/WNG-6Q8XCD3T-0
ObjectType-Article-1
SourceType-Scholarly Journals-1
ObjectType-Feature-2
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M. James Lopez, MD, PhD, Department of Pediatrics, Division of Pediatric Gastroenterology, University of Michigan Health System, Ann Arbor, MI, jamlopez@med.umich.edu
John C. Magee, MD Department of Surgery, Section of Transplant Surgery, University of Michigan Health System, Ann Arbor, MI, mageej@med.umich.edu
Address requests for offprints to: Emily M. Fredericks, PhD, 300 North Ingalls 6E18, Ann Arbor, MI 48109-5456, emfred@med.umich.edu
Emily M. Fredericks, PhD, Department of Pediatrics, Division of Child Behavioral Health, Child Health Evaluation and Research Unit, University of Michigan Health System, Ann Arbor, MI, emfred@med.umich.edu
Victoria L. Shieck, RN, BSN, CCTN, Transplant Center, University of Michigan Health System, Ann Arbor, MI, vickys@med.umich.edu
Co-Authors
Sally J. Eder, BA, Department of Pediatrics, University of Michigan Health System, Ann Arbor, MI, saleder@med.umich.edu
ISSN:1397-3142
1399-3046
DOI:10.1111/petr.12466