# Transition readiness among Chinese adolescents with chronic diseases: the promoting role of self-efficacy and willingness to engage in healthcare

## TL;DR

This study explores how self-efficacy and willingness to engage in healthcare influence transition readiness in Chinese adolescents with chronic diseases.

## Contribution

The study identifies culturally relevant predictors of transition readiness in Chinese adolescents with chronic diseases.

## Key findings

- Self-efficacy and willingness to engage in healthcare are significant positive predictors of transition readiness.
- Hemophilia, recurrent disease, and maternal caregiving are significant negative predictors of transition readiness.
- A multidimensional transition support system is needed to improve health management for adolescents with chronic diseases.

## Abstract

In China, research on transition readiness among adolescents with chronic diseases remains exploratory. Cultural and healthcare system differences limit the applicability of Western findings. This study investigates the effects of self-efficacy and willingness to engage in healthcare on transition readiness, aiming to develop culturally informed interventions for the Chinese context.

A cross-sectional study recruited 205 adolescents from a tertiary hospital in Wuhan through convenience sampling from March to October 2023. The study used validated scales to evaluate the following indicators: transition readiness (using The Self-Management and Transition to Adulthood with Rx = Treatment (STARx) Questionnaire), self-efficacy (through the General Self-Efficacy Scale), and healthcare engagement (using the questionnaire of willingness to engage in healthcare). Data analysis was conducted using SPSS 25.0 software and processed through methods such as independent sample t-test, one-way analysis of variance, pearson correlation analysis and multiple linear regression.

The overall level of transition readiness among adolescents with chronic diseases was moderate (mean score = 3.19 ± 0.58). Adolescents aged 13–15 years (β = 0.210, P = 0.003) and those over 15 years (β = 0.376, P < 0.001), along with self-efficacy (β = 0.229, P = 0.001) and willingness to engage in healthcare (β = 0.234, P < 0.001), were identified as independent positive predictors of transition readiness among adolescents with chronic diseases. Conversely, hemophilia (β= -0.350, P = 0.001), recurrent disease (β= -0.120, P = 0.037), disease deterioration (β = -0.155, P = 0.009), and maternal caregiving (β = -2.574, P = 0.011) emerged as significant negative predictors of transition readiness.

This study reveals the key factors affecting the transition readiness of adolescents with chronic diseases, and emphasizes that a multidimensional and sustainable transition support system should be constructed from psychological empowerment, family involvement and individual differences to provide a basis for improving their long-term health management ability and quality of medical care interface.