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  4. Transitioning between paediatric and adult healthcare services: a qualitative study of the experiences of young people with spinal cord injuries and parents/caregivers

Transitioning between paediatric and adult healthcare services: a qualitative study of the experiences of young people with spinal cord injuries and parents/caregivers

BMJ Open, 2022 · DOI: 10.1136/bmjopen-2022-065718 · Published: November 1, 2022

Spinal Cord InjuryHealthcareResearch Methodology & Design

Simple Explanation

This study explores the experiences of young people with spinal cord injuries (SCI) and their parents/caregivers as they transition from pediatric to adult healthcare services. The aim is to identify gaps in the transition process and co-design interventions to improve this transition. The research involved in-depth interviews with young people with SCI and their parents/caregivers to understand their experiences, needs, and recommendations for a smoother transition. The interviews focused on factors that influence the transition and suggestions for enhancing the transition experience. The study found that the transition process is often disjointed and that young people and their families need more information, support, and a coordinated handover from pediatric to adult healthcare providers. They also need a 'one-stop shop' for accessing transition information and ongoing support.

Study Duration
April to June 2021
Participants
Nine participants: five young people with SCI and four parents/caregivers
Evidence Level
Qualitative study, part of participatory action research

Key Findings

  • 1
    Participants reported a lack of information about the transition process and expressed uncertainty and anxiety about moving from pediatric to adult healthcare services.
  • 2
    The transition process was often abrupt and disjointed, with poor communication between pediatric and adult healthcare settings, leading to repeat tests and reiteration of medical history.
  • 3
    Young people and parents/caregivers emphasized the need for increased communication, a streamlined handover process, joint transition appointments, and a portable medical summary to reduce stress and improve care.

Research Summary

This qualitative study explored the experiences of young people with spinal cord injury (SCI) and their parents/caregivers during the transition from pediatric to adult healthcare services, identifying gaps in the process and gathering recommendations for improvement. Key findings highlighted a lack of information, abrupt transitions, disjointed communication between healthcare settings, and the emotional stress of repeatedly recounting medical histories. Participants recommended increased communication, streamlined handover processes, joint transition appointments, and portable medical summaries to improve the transition experience and promote better health outcomes.

Practical Implications

Improve Information Dissemination

Provide comprehensive information about the transition process, available services, and healthcare providers through brochures, websites, podcasts, and videos, accessible at the individual's own pace.

Streamline Handover Process

Implement coordinated and streamlined handover processes, including joint meetings between pediatric and adult healthcare providers and the use of portable medical summaries.

Enhance Support Services

Offer transition-specific support services, such as transition programs spanning adolescence, peer mentoring, and healthcare professionals for ongoing support and advice.

Study Limitations

  • 1
    Small sample size potentially limits the generalisability of the findings.
  • 2
    Recruitment was impacted by the COVID-19 pandemic.
  • 3
    The sample lacked cultural, linguistic and gender diversity.

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