Table 2: Comparison of stage 2 responses between pediatricians vs. internists.
Statement |
Pediatricians mean Likert rating |
Internists mean Likert rating |
P Value |
|||
I. Patient and family involvement |
||||||
1. 1. Patients undergoing transition often have difficulty trusting the new physician. |
3.79 |
3.15 |
*0.0178 |
|||
2. 2. Willingness and readiness of the patient and family are important factors for transition. |
4.75 |
4.69 |
0.6532 |
|||
3. 3. The patient and family’s attachment and familiarity with the pediatrician usually hinder a smooth transition to adult care. |
3.79 |
3.42 |
0.1798 |
|||
4. 4. Patient awareness and communication with the family regarding the transition process are both necessary. |
4.79 |
4.73 |
0.618 |
|||
5. 5. Family involvement and cooperation in the decision making play important role during transition |
4.75 |
4.69 |
0.6532 |
|||
II. Clinical/Medical |
||||||
1. 1. Adjustment of medicine dosage from pediatrics to adult can be difficult for the new physician. |
2.67 |
2.73 |
0.787 |
|||
2. 2. There should be formal endorsement between internist and pediatrician. |
4.50 |
4.50 |
0.9111 |
|||
3. 3. Proper referral and turnover of records by the pediatrician to the internist especially in long standing cases play a significant role in transition success. |
4.42 |
4.42 |
0.9306 |
|||
4. 4. There should be a clinical pathway to reconcile differences between pediatric and adult management guidelines during transition. |
4.42 |
4.12 |
0.4979 |
|||
5. 5. Patient records should be stored properly for easy retrieval and endorsement |
4.67 |
4.65 |
0.9246 |
|||
III. Healthcare provider |
||||||
1. 1. The choice of the receiving doctor should be a joint decision between the physician and the patient’s family. |
4.29 |
4.50 |
0.2977 |
|||
2. 2. Prior to referral, competency and approach of the receiving physician are important considerations. |
4.71 |
4.46 |
0.1194 |
|||
3. Personal endorsement is essential during transition. |
4.29 |
4.00 |
0.1994 |
|||
4. 4. Transitioning of patients from pediatrics to adult care should start early and must be gradual. |
4.17 |
3.73 |
0.0812 |
|||
5. 5. Communication and coordination between the pediatrician and internist should be continuous during transition process. |
4.42 |
4.23 |
0.2918 |
|||
IV. Institutional coordination process |
||||||
1. 1. There should be a hospital protocol and uniform guidelines in health care transition. |
4.33 |
3.96 |
0.1807 |
|||
2. 2. There should be interhospital coordination and referral system guideline for the transfer of care of patients. |
4.29 |
4.15 |
0.6783 |
|||
3. 3. Residents, fellows and consultants should be trained on proper referral system and transition process. |
4.71 |
4.23 |
*0.0308 |
|||
4. 4. Complete electronic records should be made available to the transition team |
4.13 |
3.96 |
0.4494 |
|||
5. 5. A transition clinic/program should be established in all hospitals. |
4.21 |
3.73 |
0.0737 |
|||
V. Psychosocial |
||||||
1. 1. Patient anxiety and readiness should be addressed by both health care providers (pediatrician/internist) for a smooth transition. |
4.67 |
4.31 |
0.0209 |
|||
2. 2. The financial capability of the family is a primary concern during transition. |
4.08 |
3.46 |
0.0152 |
|||
3. 3. A patient for transition should undergo psychological evaluation. |
3.38 |
3.23 |
0.6265 |
|||
4. 4. Transition clinic must be conducive in establishing patient rapport and confidence to the new doctor. |
4.46 |
4.15 |
0.1411 |
|||
5. 5. The transition process should be able to address the psychological and emotional impact on the patient. |
4.50 |
4.04 |
0.0174 |
*significant