408.3 Factor analysis of transition readiness assessment questionnaire for transplant patients
Tuesday May 07, 2019 from 10:00 to 11:00
Seymour Room

Kristine McKenna, United States

Transplant Psychologist

Pediatric Transplant Center

Boston Children's Hospital


Factor analysis of transition readiness assessment questionnaire for transplant patients

Kristine McKenna1, Jolie Erlacher1, Peter Forbes2, Dawn Freiberger1, Lynne Helfand1, SoYun Kwan1.

1Pediatric Transplant Center, Boston Children's Hospital, Boston, MA, United States; 2Clinical and Translational Research Program, Boston Children's Hospital, Boston, MA, United States

Background and Aims: The Transition Readiness Assessment Questionnaire (TRAQ Version 5.0) is a validated scale used to identify target areas for knowledge and skill development for emerging adults with chronic health conditions. Our institution added 10 transplant-specific questions (including about substance use and safe sex practices) to assess transplant patients’ understanding along these domains. The goal is to create a transplant-specific measure (TRAQ-Tx) and evaluate new factor structure of this questionnaire.

Methods: The TRAQ-Tx form with the additional transplant-related questions was provided to patients at least one year post-transplant who ranged in age from 12 to 25 years during outpatient clinic appointments in the heart, lung, renal, liver, and multivisceral transplant programs.  

Results: Fifty-four male and forty-eight female transplant patients completed the forms. The average age was 17.5 years (SD = 3.50). Twenty-seven of the items loaded onto one of three factors within the scale. The Skills for Self-Management (14 items) and Skills for Self-Advocacy (9 items) factors, previously identified by an initial TRAQ validation study, also were found within the transplant version. In addition, a Risk Behavior Awareness factor was identified with 4 items related to patients’ knowledge of health risks for engaging in unprotected sex or the use of substances (alcohol, non-prescribed medications, and illicit drugs). The means of these three factors were, respectively, 3.1 (SD 1.3), 4.3 (SD 0.8), and 4.4 (SD 1.0). The Self-Management and Self-Advocacy factors were highly correlated (r=.72, p<.0001). The correlation of the Risk Behavior Awareness factor with the first two factors was moderate (ranging from r=.42 to .46, p<.0001). Age was positively correlated with all three factors (r=.36 to .65, p<.001). None of the factors varied significantly by gender. Further analyses for the effects of transplant type on transition readiness factor scores also will be explored.

Conclusion: The TRAQ-Tx identified areas of informational need and skill development for adolescent and young adult transplant patients as well as provided an additional element in terms of the Risk Behavior Awareness factor. Given the additional negative implications that substance misuse and sexually transmitted infections can have on transplant patients’ health, identifying knowledge gaps early is an important step in the provision of prevention and harm reduction strategies.  Age, gender, and organ-specific considerations also are discussed in terms of in developing tailored transition readiness goals across a patient population.

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