Health Care Transition Readiness in Parents of Adolescent and Young Adult Survivors of Pediatric Cancers: A Mixed Methods Study

PURPOSE: This study aimed to better understand the phenomenon of health care transition (HCT) readiness in parents of adolescent and young adult (AYA) survivors of pediatric cancers. Specific aims were to (1) quantitatively identify factors that predict HCT readiness of parents of AYA survivors of pediatric cancers; (2) qualitatively explore the past, present, and future roles of parents related to their child's medical treatment and their potential impact on the parents' HCT readiness; and (3) integrate the quantitative and qualitative results regarding parental HCT readiness. METHODS: Parents of AYA survivors were recruited through social media to complete surveys, including the Transition Readiness Index-Parent version (TRI-P), the Perceived Stress Scale (PSS), and the PROMIS Emotional Distress-Anxiety-Short Form 4a (PEDA). Parents who completed the survey were invited to participate in semistructured interviews. Integration of findings happened during interpretation. RESULTS: Twenty-two parents completed the survey. Stepwise regression yielded a model including parental perceived stress and AYA age as predictive factors for HCT readiness. Twelve parents participated in semistructured interviews. Emergent themes were uncertainty related to HCT, parent roles during treatment, parent-AYA roles now/future, relationships with providers, and survivors' mental health challenges. Integrating the results found that most themes aligned with either the TRI-P, PSS, or PEDA, while survivors' mental health challenges were not reflected in the TRI-P. CONCLUSION: Further study, with a larger, less homogenous sample, could illuminate opportunities for potential interventions to increase HCT readiness for parents of AYA survivors.