Transition structures and timing of transfer from paediatric to adult-based care after kidney transplantation in Germany : a qualitative study

  • Objectives: It is known that transition, as a shift of care, marks a vulnerable phase in the adolescents’ lives with an increased risk for non-adherence and allograft failure. Still, the transition process of adolescents and young adults living with a kidney transplant in Germany is not well defined. The present research aims to assess transition-relevant structures for this group of young people. Special attention is paid to the timing of the process. Setting: In an observational study, we visited 21 departments of paediatric nephrology in Germany. Participants were doctors (n=19), nurses (n=14) and psychosocial staff (n=16) who were responsible for transition in the relevant centres. Structural elements were surveyed using a short questionnaire. The experiential viewpoint was collected by interviews which were transcribedverbatim before thematic analysis was performed. Results: This study highlights that professionals working within paediatric nephrology in Germany are well aware of the importance of successful transition. Key elements of transitional care are well understood and mutually agreed on. Nonetheless, implementation within daily routine seems challenging, and the absence of written, structured procedures may hamper successful transition. Conclusions: While professionals aim for an individual timing of transfer based on medical, social, emotional and structural aspects, rigid regulations on transfer age as given by the relevant health authorities add on to the challenge. Trial registration: number ISRCTN Registry no 22988897; results (phase I) and pre-results (phase II).
Author:Jenny Prüfe, Marie-Luise Dierks, Dirk Bethe, Martina Oldhafer, Silvia Müther, Julia Thumfart, Markus Feldkötter, Anja Büscher, Katja Sauerstein, Matthias Hansen, Martin Pohl, Jens Drube, Florian Thiel, Susanne Rieger, Ulrike John, Christina Taylan, Katalin Dittrich, Sabine Hollenbach, Günter Klaus, Henry Fehrenbach, Birgitta Kranz, Carmen Montoya, Bärbel Lange-Sperandio, Bettina Ruckenbrod, Heiko Billing, Hagen Staude, Reinhard Brunkhorst, Krisztina Rusai, Lars Pape, Martin Kreuzer
Pubmed Id:
Parent Title (English):BMJ open
Publisher:BMJ Publishing Group
Place of publication:London
Document Type:Article
Year of Completion:2017
Date of first Publication:2017/06/12
Publishing Institution:Universitätsbibliothek Johann Christian Senckenberg
Release Date:2018/04/19
Tag:Germany; adolescents’ health; kidney transplantation; paediatric nephrology; transfer; transition
Issue:6, e015593
Page Number:10
First Page:1
Last Page:9
Copyright information: © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.
This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
Institutes:Medizin / Medizin
Dewey Decimal Classification:6 Technik, Medizin, angewandte Wissenschaften / 61 Medizin und Gesundheit / 610 Medizin und Gesundheit
Licence (English):License LogoCreative Commons - Namensnennung-Nicht kommerziell 4.0