Master's Project Title:

Healthcare transition for YSHCN: awareness, attitudes, and barriers among healthcare providers

MCH Student:

Rebecca McCaulley

Date of Defense:

July 30, 2014


Objective: Growing numbers of children are surviving into adulthood with child – onset chronic  disease and disabilities due to advances in medicine over the last three decades. This transition  to adult – oriented care is often known to be disorganized and can result in lack of stream-lined  access to healthcare providers and in impaired health and function. Although many youth with  special health care needs (YSHCN) benefit from a process that prepares them for eventual  transition to adult care, there have been no discernible improvements in many years. Health care  providers play an important role within complex systems of care to effectively impact quality of  care for these youth. Attitudes and awareness at t he level of the healthcare provider as well as  barriers to efficacious HCT will be reviewed and will likely identify areas where improvements  can be made.

Methods: A literature review was conducted by searching Pubmed, CHINHL, Medline Ovid,  and PSYCHinfo databases for articles published between 1999 and 2013. English language  abstracts that discussed topics related to attitudes, awareness, and barriers for health care  providers working with YSHCN were reviewed. References were also studied from identified  articles for related abstracts. Data from articles selected for full review were represented for  each of the three topics on charts.

Results: A total of sixty – three articles were identified and thirty – one  were selected for this  review.  This literature re view yielded three primary themes: awareness, attitudes, and barriers.  Topics were woven within articles and often combined. More evidence was elicited of what is  known of attitudes of providers toward HCT and of existing barriers. There were few empirical  studies.

Conclusions: This literature review provides insight into the various levels of awareness  providers have, the types of HCT – related components that affect their attitudes, and the variety of  barriers they face.  More research needs to be performed to assess how healthcare providers can  better impact HCT for YSHCN. A draft needs assessment for all types of providers caring for  YSHCN is provided and more specific work in the three areas combined is recommended.