Riding the wave: A grounded theory of transplant transition in adolescents and youth adults
Bibliographic record
Abstract
Objectives: The health care transition from pediatric to adult-focused health care for adolescent and young adult (AYA) organ transplant recipients is a critical yet understudied period. Unique challenges include supporting adherence to immunosuppressive regimens and addressing psychosocial factors that impact long-term graft survival and recipient well-being. The objective of this study was to understand how AYAs prepared for and engaged in the transition process. Methods: Constructivist grounded theory, underpinned by symbolic interactionism, was employed to systematically gather, synthesize, analyze, and conceptualize qualitative data from in-depth interviews with 14 transplant recipients, their families, and pediatric nurses, and related online social media stories. Results: which they did through navigating four phases: (1) anticipating the impending transition, (2) losing security when transitioning to uncertainty, (3) seeking supportive anchors in the swell of transition, and (4) gaining a new sense of self. Conclusions: AYA transplant recipients undergo numerous changes as they enter adulthood and adult-focused health care. There are many opportunities for pediatric and adult health care providers to collaborate to strengthen support for AYA recipients and their families during this critical period. Developmental and trauma-informed approaches are recommended to support successful transition.
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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 | 0.031 | 0.015 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.003 | 0.003 |
| Science and technology studies | 0.006 | 0.020 |
| Scholarly communication | 0.007 | 0.007 |
| Open science | 0.003 | 0.006 |
| Research integrity | 0.002 | 0.004 |
| Insufficient payload (model declined to judge) | 0.001 | 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".