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Transition readiness in adolescents with blood disorders: the importance of family functioning and parent-adolescent communication style
Dissertation   Open access

Transition readiness in adolescents with blood disorders: the importance of family functioning and parent-adolescent communication style

Meredith Jayne Lutz Stehl
Doctor of Philosophy (Ph.D.), Drexel University
Aug 2005
DOI:
https://doi.org/10.17918/etd-1299
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Abstract

Blood--Diseases Clinical Psychology Hemophilia
Bleeding disorders, including hemophilia, an X-linked recessive disorder of blood coagulation, and von Willebrand disease (VWD), a more common inherited blood disorder, both result in prolonged bleeding and can involve similar treatment components (Kazazian, 1993; Kelley, 1996; Lemanek, Buckloh, Woods, & Butler, 1995; Paper & Kelley, 2002). While a majority of children with blood disorders (90% of children with hemophilia) are expected to live into adulthood, very little research has evaluated the variables thought to predict readiness for transition or successful transition from pediatric to adult health care in young adults with blood disorders (Blum et al., 1993; Gortmaker & Sappenfield, 1984). The purpose of the current study was to evaluate factors proposed by Holmbeck and Shapera (1999), including demographics, parenting-adolescent interaction, and family functioning, that are thought to predict successful adjustment in adolescence. The study also examined differences between adolescents with hemophilia and those with VWD, explored how factors predict adjustment during adolescent transition to adult health care and assessed factors thought to predict readiness for transition. Results from the study suggest few differences between adolescents with VWD and those with hemophilia and partial support for the Holmbeck and Shapera (1999) model. Demographic variables were found to play a significant role in predicting transition outcome. Results should be interpreted cautiously given the small sample size of the study and low power. Findings suggest that male adolescents and those from a low socioeconomic background may be more likely to experience poorer family functioning and increased maladjustment. Results provided support for a multi-tiered intervention program that provides minimal services to well-functioning families surrounding transition to adult care, but provides more intensive services to families that have multiple risk factors.

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