| | (1) Youth with pedLTC are potentially juxtaposed between the hope of achieving new young adult milestones and their own end of life trajectory. | |
| | (2) Health care transitions are embedded with the broader systems and are connected to family, social, educational, cultural, and religious factors [3, 23]. | |
| | (3) Development of comparable medical and support services did not follow interventions to increase life expectancy [3–5]. | |
| | (4) Current transitional services from integrated pediatric services to the adult health and social service sectors are limited in their breadth, scope, and effectiveness to meet the needs of young adults with pedLTC [16, 20]. This could result in increased morbidity, isolation, and inadequate support to fulfill their aspirations for intimacy, independence, education, work, and interpersonal relationships [6, 21]. | |
| | (5) Resiliency, vulnerability, personal factors (cognitive capacity, temperament, self-direction, imagination, values, meaning of transitional phase, and motives), parental influences (availability, history of acceptance to youth decision making, attitudes or preoccupation with youth’s strengths or limits, and view of impact of youth’s pedLTC on siblings and family), and external supports (parents, siblings, extended family, teachers, and community/religious/cultural mentors and volunteers) can influence the youth’s experience of the transition process [21]. | |
| | (6) Health and other service providers in the adult care sector could have limited awareness of the complexity of the issues for youth with pedLTC and/or do not have a mandate and/or the resources to provide integrated services to young adults with pedLTC [30, 31, 33]. | |
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