Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Canada.
Centre for Addiction and Mental Health, Toronto, Canada.
Child Care Health Dev. 2023 Mar;49(2):248-257. doi: 10.1111/cch.13035. Epub 2022 Jul 31.
Among youth with psychiatric disorders, the transition from child to adult mental health services is a period of vulnerability to discontinuous care and service disengagement. Regular assessment of transition readiness has been identified as a core component of transition planning, contributing to successful care transitions. The Transition Readiness Assessment Questionnaire (TRAQ) 5.0 is a 20-item questionnaire that measures transition readiness in youth preparing to transition to adult care. Although the TRAQ has been validated and used across many health settings, it has not been validated in youth with primarily mental health concerns. The objective of this study was to validate the TRAQ for use among youth accessing mental health services.
This study used the Longitudinal Youth in Transition Study baseline cohort, which consists of 237 clinically referred youth (aged 16-18 years) receiving outpatient mental health treatment. Psychometric evaluation of the TRAQ 5.0 included confirmatory factor analysis (CFA), assessment of internal consistency, testing convergent validity using the Dimensions of Emerging Adulthood (IDEAS) and Difficulty in Emotional Regulation (DERS) scales, criterion validity using a question on whether the participant had talked about transition with their clinician and known-group testing based on age.
The CFA indicated adequate fit of the five-factor TRAQ structure. The overall scale (=.86) and three of the subscales demonstrated adequate internal consistency. As hypothesized, overall TRAQ scores were higher for youth who had discussed transition and those aged 18. Small correlations were found between the overall TRAQ score and measures of developmental maturity (IDEAS) and emotional awareness (DERS); however, certain subscales did not demonstrate correlation with these constructs.
The TRAQ 5.0 appears to be valid tool to assess the transition readiness of youth in outpatient mental health services. Additional work needs determine whether findings are similar among specific mental health conditions, including substance use disorders and psychotic disorders.
在患有精神障碍的年轻人中，从儿童期到成人期精神卫生服务的过渡时期存在着护理不连续和服务脱节的风险。定期评估过渡准备情况已被确定为过渡计划的核心组成部分，有助于实现成功的护理过渡。过渡准备评估问卷（TRAQ）5.0 是一个 20 项的问卷，用于衡量准备过渡到成人护理的年轻人的过渡准备情况。尽管 TRAQ 已经在许多健康环境中得到验证和使用，但尚未在主要关注心理健康的年轻人中得到验证。本研究的目的是验证 TRAQ 在接受精神卫生服务的年轻人中的使用。
本研究使用了纵向青年过渡研究基线队列，该队列由 237 名接受门诊精神卫生治疗的临床转诊青年（年龄 16-18 岁）组成。TRAQ 5.0 的心理测量评估包括验证性因素分析（CFA）、内部一致性评估、使用维度的成年期（IDEAS）和情绪调节困难（DERS）量表评估聚合效度、使用参与者是否与临床医生讨论过过渡的问题评估效标效度，以及基于年龄的已知组检验。
CFA 表明 TRAQ 五因素结构具有良好的拟合度。总体量表（=.86）和三个分量表表现出足够的内部一致性。如假设的那样，讨论过过渡的青年和 18 岁的青年的 TRAQ 总分较高。TRAQ 总分与发展成熟度（IDEAS）和情绪意识（DERS）的测量值之间存在较小的相关性；然而，某些分量表与这些结构没有相关性。
TRAQ 5.0 似乎是评估门诊精神卫生服务中年轻人过渡准备情况的有效工具。需要进一步的工作来确定这些发现是否在特定的心理健康状况中相似，包括物质使用障碍和精神病障碍。
