290 Describing relationships between psychosocial outcomes and readiness for transition in adolescent and young adult patients with juvenile idiopathic arthritis: a pilot study

Abstract

Background: The transition from paediatric to adult care should be a multifactorial and multidisciplinary process that addresses patients' medical, psychosocial, and educational needs. However, there is evidence to suggest that the paediatric-adult transition is not always well-managed, and is often associated with the deterioration of health in patients with chronic illnesses. Despite this, there is very little existing data on the relationships between psychosocial outcomes (e.g., anxiety, social support) and readiness to transition from paediatric to adult services in adolescent and young adult patients with juvenile idiopathic arthritis (JIA). This study therefore aims to examine the relationships between psychosocial outcomes and readiness to transition from paediatric to adult rheumatology services in adolescent and young adult patients aged 10-25 years diagnosed with JIA at a single centre. Methods: Participants are invited to complete a self-report questionnaire while waiting for routine clinic appointments. The questionnaire is comprised of several validated measures that assess patients' psychosocial outcomes (generalised anxiety, pain-related anxiety, pain-related thoughts, depression, prosocial and problem behaviours, social functioning, family functioning, quality of life) and readiness to transition from paediatric to adult health services (knowledge and confidence about the transition, disease-related self-efficacy). In total, 40 adolescent patients aged 10-16 years, together with a parent/guardian, will be recruited at Sheffield Children's Hospital and 40 young adult patients aged 16-25 years will be recruited at Sheffield Teaching Hospitals. To date, 17 adolescent patients (Mage = 12.41 years, 10 females) and 28 young adult patients (Mage = 19.68 years, 19 females) have participated in this study. This study has received full ethical approval. Informed consent was obtained from patients aged 16-25 years and parents/ guardians of patients aged 10-15 years, and informed assent was obtained from patients aged 10-15 years. Results: Spearman correlation coefficients were conducted to examine the relationships between psychosocial outcomes and readiness for transition. Correlations were conducted separately for pre-transfer and post-transfer patients. The preliminary findings show that greater knowledge and confidence about the transition to adult health services was associated with a better quality of life and more prosocial behaviours in pre-transfer patients, but lower pain-related anxiety and depression levels in post-transfer patients. Greater levels of diseaserelated self-efficacy were associated with a better quality of life and better family functioning in pre-transfer patients, and lower generalised anxiety levels, lower pain-related anxiety levels, lower depression levels, fewer pain-related thoughts, a better quality of life, and greater social functioning in post-transfer patients. Conclusion: These preliminary findings provide initial evidence to suggest that better psychosocial outcomes are strongly associated with greater knowledge and confidence about the transition to adult health services and greater disease-related self-efficacy in both pretransfer and post-transfer patients with JIA.