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American Journal of Public Health Research. 2021, 9(5), 222-228
DOI: 10.12691/AJPHR-9-5-6
Original Research

Experiences and Perceptions on Transitioning from Pediatric to Adult Care Among Patients with Sickle Cell Disease in an NYC Hospital

Sharfun Ara1 and Collette M. Brown1,

1School of Allied Health Professions, Monroe College, Bronx, NY, USA

Pub. Date: August 09, 2021

Cite this paper

Sharfun Ara and Collette M. Brown. Experiences and Perceptions on Transitioning from Pediatric to Adult Care Among Patients with Sickle Cell Disease in an NYC Hospital. American Journal of Public Health Research. 2021; 9(5):222-228. doi: 10.12691/AJPHR-9-5-6

Abstract

Sickle Cell Disease (SCD) is a genetic disease and a major global public health concern. The transition process from pediatric to adult care is complicated and frustrating for many patients and physicians. This qualitative, phenomenological study explored the perceptions and experiences of Physicians-In-Training (PIT) and young adult patients regarding the transition process from pediatric to adult care. A total of 12 participants (four pediatric PIT and eight young adult patients with SCD) from a hospital in New York City participated in the study. Data were collected through semi-structured interviews, which were audio-recorded, transcribed, and hand-coded into themes. The findings revealed that young adults with SCD had negative experiences and perceptions throughout the transition process. Inadequate information about the transition, poor relationships with adult providers, and long waiting times in the ER reduced the quality of care of patients with SCD. Social support during the transition process came mainly from their parents. Young adults believed that there should be a better relationship with the adult providers, and that patients with SCD and the adult clinical team should be educated about the transition process. Seventy-five percent (75%) of the PIT mentioned that transition to adult care usually starts at age 21; however, they believed that the transition process should start at age 15. They lacked knowledge about the transition process and support services for patients with SCD. They also reported hesitation of pediatric patients to transfer to adult care. They expressed concern that young adults might not be adherent to their medications and schedule their appointments when needed. The transition process should include adequate preparation, patient education, social support, communication between pediatric and adult settings, and a relationship between patients and adult providers.

Keywords

Sickle Cell Disease, transition process, experiences, perceptions, young adult patient, pediatric physician

Copyright

Creative CommonsThis work is licensed under a Creative Commons Attribution 4.0 International License. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/

References

[1]  Centers for Disease Control and Prevention (CDC). “Sickle cell disease in Georgia.” (n.d.). Available: http://www.cdc.gov/ncbddd/sicklecell/documents/scd_in_ga_prov.pdf.
 
[2]  Serjeant, G. R., “The natural history of sickle cell disease” Cold Spring Harb Perspect Med, 3, a011783, 2013.
 
[3]  Lee, L., Askew, R., Walker, J., Stephen, J. & Robertson-Artwork, A., “Adults with sickle cell disease: An interdisciplinary approach to home care and self-care management with a case study” Home Healthcare Nurse, 30(3), 172-183, 2012.
 
[4]  National Heart, Lung, and Blood Institute. (2012). What is sickle cell anemia? 2012. Available: http://www.nhlbi.nih.gov/health/health-topics/topics/sca.
 
[5]  Rees, D. C., Williams, T. N., & Gladwin, M. T., “Sickle-cell disease,” Lancet, 376, 2018-2031, 2010.
 
[6]  Ballas, S.K., Lieff S., Benjamin, L.J., Dampier, C.D., Heeney, M.M., Hoppe, C., Johnson, C.S., Rogers, Z.R., Smith-Whitey, K., Wang, W.C., Telen, M.J., “Definitions of the phenotypic manifestations of sickle cell disease,” American Journal of Hematology, 85(1), 6-13, 2010.
 
[7]  Treadwell, M., Schrier, S., & Tirnauer, J., “Transition from pediatric to adult care: sickle cell disease,” Up to Date,1-32, 2018.
 
[8]  Piel, F. B., Hay, S. I., Gupta, S., Weatherall, D. J., Williams, T. N., “Global burden of sickle cell anemia in children under five, 2010-2050: Modeling based on demographics, excess mortality, and interventions,” PLoS Medicine, 10(7), e1001484, 2013.
 
[9]  Centers for Disease Control and Prevention (CDC). Sickle cell disease (SCD): Data and statistics. 2019. [Online]. Available: http://www.cdc.gov/ncbddd/sicklecell/data.html.
 
[10]  Loiselle, K., Lee, J. L., Szulczewski, L., Drake, S., Crosby, L. E., & Pai, A. L., “Systematic and meta-analytic review: medication adherence among pediatric patients with sickle cell disease” Journal of Pediatric Psychology, 41(4), 406-418, 2015.
 
[11]  Adams-Graves, P. & Bronte-Jordan, L., “Recent treatment guidelines for managing adult patients with sickle cell disease: challenges in access to care, social issues, and adherence,” Expert Review of Hematology, 9(6), 541-552, 2016.
 
[12]  Quinn, C. T., “Sickle cell disease in childhood: from newborn screening through transition to adult medical care” Pediatric Clinics of North America, 60(6), 1363-1381, 2013.
 
[13]  Ilesanmi, O. O., “Gender differences in SCD crises: implications for genetic counselling and psychotherapy,” International Journal of Information and Education Technology, 4(2), 215, 2014.
 
[14]  Lughetti, L., Bigi, E., & Venturelli, D., “Novel insights in the management of sickle cell disease in childhood” World Journal of Clinical Pediatrics, 5(1), 25-34, 2016.
 
[15]  Association of Maternal and Child Health Programs, “Using the six core elements of health care transition in Medicaid managed care,” Available: http://www.amchp.org/programsandtopics/BestPractices/InnovationStation/ISDocs/Got%20Transition.pdf.
 
[16]  Got Transition, “The six core elements of health care transition,” 2021. Available: https://www.gottransition.org/six-core-elements/.
 
[17]  Smith, W. R., Sisler, I. Y., Johnson, S., Lipato, T. J., Newlin, J. S., Owens, Z. S., Morgan, A. M., Treadwell, M. J., & Polak, K. (2019). Lessons Learned from Building a Pediatric-to-Adult Sickle Cell Transition Program. Southern medical journal, 112(3), 190-197.
 
[18]  Saulsberry, A.C., Porter, J. S., and Hankins, J., “A program of transition to adult care for sickle cell disease,” American Society of Hematology, 2019(1), 496-504, 2019.
 
[19]  Cerns, S., McCracken, C., Rich, C., “Optimizing adolescent transition to adult care for sickle cell disease,” Medical Surgical Nursing, 22(4), 255-258, 2013.
 
[20]  Treadwell, M., Telfair, J., Gibson, R. W., Johnson, S., Osunkwo, I., “Transition from pediatric to adult care in sickle cell disease: Establishing evidence-based practice and directions for research,” American Journal of Hematology, 86(1), 116, 2011.
 
[21]  Sonneveld, H. M., Starting, M. M. H., van Staa, A. & Nieboer, A. P., “Gaps in transitional care: What are the perceptions of adolescents, parents and providers?” Child Care Health and Development, 39(1), 69-80, 2013.
 
[22]  O’Connor, S., Hanes, D., Lindsey, A., Weiss, M., Petty, L. & Overcash, J., “Attitudes among healthcare providers and patients diagnosed with sickle cell disease: frequent hospitalizations and stressors,” Clinical Journal of Oncology Nursing, 18(6), 675-680, 2014.
 
[23]  Higginson, A., Forgeron, P., Dick, B., & Harrison, D., “Moving on: A survey of Canadian nurses’ self-reported transition practices for young people with chronic pain” Canadian Journal of Pain, 2(1), 169-181, 2018.
 
[24]  Porter, J. S., Wesley, K. M., Zhao, M. S., Rupff, R. J., & Hankins, J. S., “Pediatric to adult care transition: perspectives of young adults with sickle cell disease,” Journal of Pediatric Psychology, 42(9), 1016-1027, 2017.
 
[25]  Sobota, A., Neufeld, E. J., Sprinz, P., & Heeney, M. M., “Transition from pediatric to adult care for sickle cell disease: results of a survey of pediatric providers” American Journal of Hematology, 86(6), 512, 2011.
 
[26]  Feliu, M. H., Wellington, C., Crawford, R. D., Wood, M., Edwards, L. Byrd, G., & Edwards, C. L., “Opioid “management and dependency among adult patients with sickle cell disease” Hemoglobin, 35(5-6), 485-494, 2011.
 
[27]  Centers for Disease Control and Prevention (CDC), “Sickle Cell Disease: Taking charge of your health and healthcare,” 2020. Available: https://www.cdc.gov/ncbddd/sicklecell/features/sickle-cell-transition.html
 
[28]  Van Staa, A., Jedeloo, S., Van Meeteren J., & Latour J. M., “Crossing the transition chasm: experiences and recommendations for improving transitional care of young adults, parents, and providers” Child Care Health and Development, 37(6), 821-832, 2011.