The relationship of health care transition readiness to disease-related characteristics, psychosocial factors, and health care outcomes: preliminary findings in adolescents with chronic kidney disease.
OBJECTIVE
The current study utilized the Disability-Stress-Coping Model to conceptualize how disease-related risk factors (disease severity, age of diagnosis, and disease burden) and psychosocial resilience factors (coping efficacy, family cohesion, and quality of life) influence health care transition (HCT) readiness when controlling for age and disease severity [1]. Additionally, the impact of low HCT readiness on emergency room visits and medication adherence was examined.


METHODS
The sample was comprised of 41 adolescents with chronic kidney disease (CKD) who ranged in age from 13 to 18 years (Mean=15.7). Multiple regression analyses were conducted.


RESULTS
None of the disease-related factors were associated with HCT readiness. Of the psychosocial factors, only family cohesion was a significant predictor and accounted for 10% unique variance. Transition readiness was significantly related to both the number of self-reported emergency room visits and medication adherence such that high readiness was related to fewer visits to the emergency room and better medication adherence; these variables accounted for 6.4% and 14.9% of the unique variance respectively.


CONCLUSIONS
These findings suggest that disease-related risk factors may be less critical to predicting transition readiness than resilience factors such as family cohesion. Additionally, when adolescents have low transition readiness they are likely to experience significant negative health outcomes.
University of North Carolina-Chapel Hill, Chapel Hill, NC, USA.
Nicole
N
Fenton
Department of Pediatrics, University of North Carolina School of Medicine, Chapel Hill, NC, USA.
Maria
M
Ferris
School of Medicine, East Carolina University, Greenville, NC, USA.
Zion
Z
Ko
University of North Carolina-Chapel Hill, Chapel Hill, NC, USA.
Karina
K
Javalkar
Departments of Allied Health Sciences and Psychiatry University of North Carolina School of Medicine, Chapel Hill, NC, USA.
Stephen R
SR
Hooper
D000293:Adolescent; D000294:Adolescent Behavior / Q000523:psychology*; D005260:Female; D006304:Health Status; D006801:Humans; D008297:Male; D010349:Patient Compliance / Q000523:psychology*; D012044:Regression Analysis; D051436:Renal Insufficiency, Chronic / Q000523:psychology* / Q000628:therapy*; D012648:Self Care / Q000523:psychology; D011795:Surveys and Questionnaires; D060305:Transition to Adult Care
Health care-related transition; chronic kidney disease; factors affecting transition; transition readiness