The potential contribution of critical theories in healthcare transition research and practice

Abstract

Background

Healthcare transition has been established as a significant topic of interest in pediatric rehabilitation. Healthcare transition research has primarily focused on barriers to self-management and achievement of a productive adulthood. Healthcare transition experts have recently called for further attention to social structural factors. Theoretical approaches are, therefore, needed to account for how such factors shape the lives of youth with disabilities, particularly those who experience marginalization and social exclusion.

Purpose

Taking up this call, the aim of this paper is to examine the potential contributions of two critical theories to healthcare transition research and practice.

Methods

Review two theories – intersectionality and critical discourse analysis.

Results

Intersectionality highlights how multiple intersecting social locations and social structures interact with youth’s experiences, choices and health care needs. Critical discourse analysis focuses on how discourses and assumptions in healthcare transition research and practice contribute to marginalization and can be resisted and changed by youth, families, researchers, and clinicians.

Conclusions

The uptake of critical theories within health care transition research and practice can account for the complex interplay of social structures, power relations and youth’s experiences. Such analysis can contribute to refining assessments and developing interventions that reflect how marginalization and exclusion impact youth’s well-being.

IMPLICATIONS FOR REHABILITATION

• While critical theories have been applied in health and rehabilitation, there has been limited uptake of these theories in healthcare transition research and practice.

• Critical theories can promote awareness of how youth’s experiences, choices and actions throughout the healthcare transition process are shaping and shaped by structural factors and assumptions about a productive adulthood.

• Applying critical theories in healthcare transition practice involves being responsive to the structural factors that may be shaping youth’s experiences, choices and opportunities.

• Intersectional and critical discourse analyses can surface how to reduce social exclusion and marginalization for youth transitioning to adulthood through analyses of language, power, dominant discourse and practices amenable to change.

Keywords:

• Transition
• critical theory
• adolescent
• young adult
• disability

Acknowledgements

We wish to thank Drs. Colleen Varcoe, Judith Lynam, Yani Hamdani and Gail Teachman for sharing their experiences and insights as critically-oriented health researchers with Ms. Straus in the early stages of conceptualizing this paper.

Disclosure statement

The authors declare no actual or potential conflicts of interest.