Master's Project Title:

The Role of Autonomy Support in the Health Care Transition of Youth Living with Arthritis

MCH Student:

Courtney Wells

Date of Defense:

June 2011


Objective: To explore the role of healthcare providers in supporting autonomy development among youth with arthritis, age 14-19. Specifically, we seek to describe relationships between autonomy support and both adolescent-structured care and healthcare transition (HCT) planning.

Methods: We used data from an online survey of youth with rheumatologic conditions (n=134). Autonomy support was measured using 6 items from the Healthcare Climate Questionnaire, dichotomized into high and low groups using a median split. Adolescent-structured care was assessed with 2 questions from the Young Adult Healthcare Survey asking about privacy and confidentiality in the provision of care. Whether respondents had discussed healthcare transition with their healthcare provider was measured with 2 questions from the National Survey of Children with Special Health Care Needs.

Results: Overall, only one third of youth reported talking to their rheumatologist about transferring to adult medicine; less than half had talked with any healthcare provider about their health care needs as they become an adult. Forty percent reported being seen privately by a rheumatologist or being informed about confidentiality. Bivariate analyses reveal significant associations between autonomy support and both adolescent-structured care and HCT planning.

Conclusion: Findings indicate that autonomy support from healthcare providers may play a role in the development of transition planning skills for youth living with arthritis.