Table 3.

Mean and median Likert ratings and Wilcoxon rank order of stage 3 survey items (Bonferroni correction: p < 0.0017, Friedman test p < 0.0001).

Item	Category	Mean Likert Rating	Median Likert Rating	Wilcoxon Rank
1. Overprotective parents hamper medical treatment.	patient-related	3.25	4	22
2. It is difficult to involve parents without interfering with the development of patient autonomy.	patient-related	3.07	3	21
3. Adult nephrologists’ training in youth health and adolescent medicine is limited.	qualification	2.89	3	19
4. There is a lack of qualified staff to care for the nonmedical needs of patients.	resources	2.86	3	19
5. Difficulties at school or work hamper medical treatment.	patient-related	2.82	3	19
6. Adult nephrologists’ training in rare, syndromal, and congenital diseases is limited.	qualification	2.82	3	19
7. Financing structures and administrative regulations do not allow for coverage of nonmedical needs.	resources	2.79	3	18
8. Patients lack autonomy.	patient-related	2.75	3	18
9. The relative scarcity of paediatric renal conditions makes it difficult for adult nephrologists to gain experience in the field.	qualification	2.71	3	18
10. Patients are oblivious to the severity of their disease.	patient-related	2.64	3	18
11. Patients are overstrained by too many changes occurring at the same time (e.g., medical transition plus school, education, and independence from parents).	preparation & cooperation	2.75	3	17
12. Structures of integrated health care during transition (e.g., transition clinics, side-by-side consultations, alternating consultations) are missing.	preparation & cooperation	2.71	3	17
13. Patients lack the ability to sufficiently express their needs.	patient-related	2.64	3	17
14. Patients lack sense of responsibility.	patient-related	2.61	2,5	17
15. Patients and/or their families have exaggerated expectations regarding the work and time resources of the adult nephrologist.	patient-related + resources	2.64	2,5	16
16. Training (e.g., seminars, training courses) in paediatric nephrology for adult nephrologists is scarce.	qualification	2.54	3	16
17. Health care regulations do not allow sufficient time to adequately care for the complex medical needs of former paediatric patients.	resources	2.46	2	15
18. Former paediatric patients are more often nonadherent (medication, appointments) compared with my other patients.	Patient-related	2.43	3	15
19. Meeting the special needs of former paediatric patients is difficult.	resources	2.36	2	14
20. Access to paediatric patient records is difficult.	Preparation & cooperation	2.29	2	14
21. Patients lack emotional maturity.	Patient-related	2.29	2	14
22. Information beyond medical facts (e.g., social history, behavioural difficulties, substance abuse) is missing.	preparation & cooperation	2.25	2	13
23. Cooperation with other medical specialists is difficult in cases of syndromic or multimorbid patients.	preparation & cooperation	2.25	2	13
24. Patients are often insufficiently prepared for transfer.	preparation & cooperation	2.18	2	13
25. Former paediatric patients distrust me because I cannot prescribe some medications they are used to.	resources	2.14	2	12
26. The handing-over is insufficient: relevant data are lacking, provided too late, or not at all provided until requested.	preparation & cooperation	2.11	2	12
27. Patients encounter adult nephrologists with scepticism and refusal.	patient-related	2.11	2	11
28. Patients are not able to name their primary disease.	patient-related	1.96	2	11
29. High turnover of medical staff makes it difficult for patients to build trust.	resources	1.86	2	10
30. It is difficult to contact the paediatric nephrologists at university hospitals.	preparation & cooperation	1.61	1	8