Factors associated with transition readiness among adolescents and young adults with spina bifida in South Korea

This study aimed to examine the factors associated with transition readiness based on the healthcare transition model among adolescents and young adults (AYAs) with spina bifida (SB) in the individual (self-management and self-efficacy), family or social support (family function and social support), healthcare system, and environmental (transition environment) domains. Using face-to-face and online surveys, we conducted a cross-sectional study on AYAs with SB in South Korea. The participants were aged 13-25 years. Data were analyzed using descriptive statistics, t test, one-way analysis of variance, Pearson's correlation coefficients, and multiple regression analysis. A total of 110 AYAs with SB participated in this study. Their mean age was 19.85 (SD = 3.65) years. The mean score of transition readiness was 3.89 (SD = 0.70) out of 5. Transition readiness was statistically significantly associated with general (age), clinical (mobility), and individual (self-management) characteristics and family or social support (social support) and the healthcare system. These results suggest that it is necessary to develop tailored transition care programs that consider factors associated with transition readiness for AYAs with SB. The findings of this study increase our understanding of the transition readiness of AYAs with SB, which can help in the development of effective transition strategies.

Illness Experiences of Adults with Spina Bifida: Protecting the Whole Self

PURPOSE

To understand and describe the illness experiences of adults with spina bifida (SB) which is an incurable birth defect and chronic condition that must be managed throughout life.

METHODS

A qualitative study using grounded theory was adopted. Data were collected through individual interviews with 16 adults with SB between 2016 and 2017 in South Korea. All interviews were audiotaped, and the transcribed data were analyzed using constant comparative analysis.

RESULTS

The basic socio-psychological process that underlies the illness experiences of adults with SB was identified as protecting the whole self. This consists of three stages: strict self-concealment, attempting self-disclosure, and balancing between self-concealment and self-disclosure. These stages reveal a process of establishing a firm sense of self by freeing oneself from the shame and stigma of society. Three different patterns of living emerged as a result: living as a non-disabled person, living as a marginal person between non-disabled and disabled, and living as a disabled person.

CONCLUSION

Adults with SB struggle to protect their whole self while managing their chronic conditions by having to constantly balance between self-concealment and self-disclosure. Intervention for adults with SB needs to be based on the stage of sociopsychological maturation. In the early stage, intervention needs to be focused on self-concealment to help establish a firm sense of self. On the other hand, in the later stage when psychological maturity occurs, an intervention that focuses on self-disclosure would be helpful so as not to be isolated from society.