Transition to Adult-Oriented Health Care: Perspectives of Youth and Adults with Complex Physical Disabilities
Bibliographic record
Abstract
Nancy L. Younga*, Wendy S. Bardenb, Wendy A. Millsc, Tricia A. Burked, Mary Law PhDe & Katherine Boydellfa Nancy L. Young, PhD, is affiliated with School of Rural and Northern Health, Laurentian University, Sudbury, Ontario, Canada; Child Health Evaluative Sciences, The SickKids Research Institute, Toronto, Ontario, Canada; and Department of Paediatrics, The University of Toronto, Toronto, Ontario, Canada.b Wendy S. Barden, MSc, is affiliated with Department of Rehabilitation Services, SickKids, Toronto, Ontario, Canada.c Wendy A. Mills, MSW, is affiliated with Child Health Evaluative Sciences, The SickKids Research Institute, Toronto, Ontario, Canada.d Tricia A. Burke, BA, is affiliated with School of Rural and Northern Health, Laurentian University, Sudbury, Ontario, Canada.e Mary Law, PhD, is affiliated with School of Rehabilitation Science, Institute of Applied Health Sciences, McMaster University, Hamilton, Ontario, Canada.f Katherine Boydell, PhD, is affiliated with Child Health Evaluative Sciences, The SickKids Research Institute, Toronto, Ontario, Canada and Department of Psychiatry, The University of Toronto, Toronto, Ontario, Canada.Address correspondence to: Nancy L. Young, PhD, Laurentian University, 935 Ramsey Lake Road, Sudbury, Ontario, Canada, P3E 2C6 (E-mail: nyoung@laurentian.ca).This research was supported by a research grant from the Canadian Institutes for Health Research (CIHR). Dr. Young holds a Canada Research Chair, which is also funded by CIHR.We are extremely thankful to the Children's Treatment Centers who partnered with us on this project: Children's Rehabilitation Centre-Algoma, Bloorview Kids Rehab, Erinoak, KidsAbility, Ottawa Children's Treatment Centre, and Sudbury Regional Hospital Children's Treatment Centre. Finally, it is important to recognize the patients and their families; without their support this information would not be available.ABSTRACT.Introduction: The transition to adulthood is extremely difficult for individuals with disabilities. We sought to explore the specific issue of transition to adult-oriented health care in a Canadian context. Methods: We conducted semi-structured individual interviews with 15 youth and 15 adults with cerebral palsy, spina bifida, and acquired brain injuries of childhood, and their parents (n = 30). Respondents discussed their health care services, their experience with clinical transition, and contributing factors. We analyzed the transcripts using qualitative methods. Results: All participants identified challenges in transition, including: lack of access to health care; lack of professionals' knowledge; lack of information and uncertainty regarding the transition process. Two solutions were identified: early provision of detailed information and more extensive support throughout the clinical transition process. Discussion: The challenges of clinical transition were universal. More extensive information and support is needed during transition to ensure an efficient move to appropriate adult-oriented health care.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.009 | 0.004 |
| Scholarly communication | 0.003 | 0.002 |
| Open science | 0.001 | 0.004 |
| Research integrity | 0.001 | 0.002 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".