Factors Predicting Transition Readiness in Adolescents with Kidney or Urinary Tract Diseases: A Cross-Sectional Study
DOI:
https://doi.org/10.60099/prijnr.2025.273831Keywords:
Adolescent, Healthcare transition, Transition readiness, Kidney disease, Urinary tract diseaseAbstract
Adolescents with kidney or urinary tract diseases require long-term management; thus, assessing transition readiness is essential for identifying the skills needed for disease management and ensuring continuity of care. Transition readiness is the process of building the capacity of adolescents to be involved in medical care to prepare for, continue, and complete healthcare transition. This cross-sectional study examined transition readiness and its predictors among 113 adolescents (aged 12-18) with kidney or urinary tract diseases from two hospitals in Bangkok, Thailand. Data were collected using the Sociodemographic Questionnaire, the Screen for Child Anxiety Related Emotional Disorders, the Health Responsibility Questionnaire, the Perceived Social Support from Family and Friends, and the Transition Readiness Assessment Questionnaire. Data were analyzed using descriptive statistics and hierarchical multiple regression analysis.
Results revealed that 50.4% of participants demonstrated suboptimal transition readiness, particularly in appointment keeping and tracking health issues. Age, family and peer support, anxiety, and health responsibility predicted 41% of the variance in transition readiness, with health responsibility being the strongest predictor, followed by anxiety and peer support, respectively. Even though family support does not directly predict transition readiness, it indirectly influences the readiness by reducing anxiety and enhancing health responsibility. Thus, family support is a very important protective factor in transition readiness. These findings suggest that nurses should emphasize transition preparation to enhance family and peer support, encourage health responsibility, and reduce anxiety, thereby strengthening transition preparedness among adolescents with kidney or urinary tract diseases. This intervention should be tested before it can be used in practice.
References
Harambat J, Madden I. What is the true burden of chronic kidney disease in children worldwide? Pediatr Nephrol. 2023;38(5):1389-93. doi:10.1007/s00467-022-05816-7 DOI: https://doi.org/10.1007/s00467-022-05816-7
Kidney Disease: Improving Global Outcomes (KDIGO) CKD Work Group. KDIGO 2024 Clinical Practice Guideline for the Evaluation and Management of Chronic Kidney Disease. Kidney Int. 2024;105(4S):S117-S314. doi:10.1016/j.kint.2023.10.018 DOI: https://doi.org/10.1016/j.kint.2023.10.018
Dotis J, Pavlaki A, Printza N, Stabouli S, Printza A, Papachristou F, et al. Quality of life in children with chronic kidney disease. Pediatr Nephrol. 2016;31(12):2309-16. doi: 10.1007/s00467-016-3457-7. DOI: https://doi.org/10.1007/s00467-016-3457-7
Ministry of Public Health. Public Health Statistics A.D.2022 [Internet]. 2022 [cited 2025 Apr 1]. Available from: https://spd.moph.go.th/wpcontent/uploads/2022/11/Hstatistic64.pdf (in Thai).
Aier A, Pais P, Raman V. Psychological aspects in children and parents of children with chronic kidney disease and their families. Clin Exp Pediatr. 2022;65(5):222-9. doi: 10.3345/cep.2021.01004. DOI: https://doi.org/10.3345/cep.2021.01004
Blum RW, Garell D, Hodgman CH, Jorissen TW, Okinow NA, Orr DP, et al. Transition from child-centered to adult health-care systems for adolescents with chronic conditions. J Adolesc Health. 1993;14(7):570-6. doi: 10.1016/1054-139x(93)90143-d. DOI: https://doi.org/10.1016/1054-139X(93)90143-D
White PH, Cooley WC. Supporting the health care transition from adolescence to adulthood in the medical home. Pediatr. 2018;142(5):e20182587. doi: 10.1542/peds.2018-2587. DOI: https://doi.org/10.1542/peds.2018-2587
Vainman S, Heller False Speiser MM, Posadas Martinez ML, Barrenechea M, Plotkin L, Schufer de Piwnica M, et al. Experience with the transition process of adolescents with chronic diseases from pediatric to adult care in a general hospital. Arch Argent Pediatr. 2022;120(6):398-404. doi: 10.5546/aap.2022.eng.398. DOI: https://doi.org/10.5546/aap.2022.eng.398
Fenton N, Ferris M, Ko Z, Javalkar K, Hooper SR. 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. J Pediatr Rehabil Med. 2015;8(1):13-22. doi: 10.3233/PRM-150314. DOI: https://doi.org/10.3233/PRM-150314
Allemang B, Dimitropoulos G, Patten SB, Sitter KC, Brobbey A, Mackie AS, et al. Association between transition readiness and mental health comorbidity in youth with chronic health conditions. J Pediatr Nurs. 2022;67:161-7. doi:10.1016/j.pedn.2022.09.012 DOI: https://doi.org/10.1016/j.pedn.2022.09.012
Kelly CS, Berg CA, Ramsey MA, Baker AC, Donaldson DL, Swinyard MT, et al. Relationships and the development of transition readiness skills into early emerging adulthood for individuals with type 1 diabetes. Child Health Care. 2018;47(3):308-25. doi:10.1080/02739615.2017.1354294 DOI: https://doi.org/10.1080/02739615.2017.1354294
Howsley H, Dunkley L, Calvert R, Hawley SJ, Edgerton J, Forsythe M, et al. Psychosocial factors associated with transition readiness in adolescents and young adults with juvenile idiopathic arthritis. Rheumatol. 2018;57(Suppl 8). doi:10.1093/rheumatology/key273.003 DOI: https://doi.org/10.1093/rheumatology/key273.003
Wright EK, Williams J, Andrews JM, Day AS, Gearry RB, Bampton P, et al. Perspectives of paediatric and adult gastroenterologists on transfer and transition care of adolescents with inflammatory bowel disease. Intern Med J. 2014;44(5):490-6. doi:10.1111/imj.12402 DOI: https://doi.org/10.1111/imj.12402
Pakdeeprom B, In-Iw S, Chintanadilok N, Wichiencharoen K, Manaboriboon B. Promoting factors for transition readiness of adolescent chronic illnesses: experiences in Thailand. J Med Assoc Thai. 2012;95(8):1028-34.
Kittivisuit S, Lerkvaleekul B, Soponkanaporn S, Pruksakorn D, Vilaiyuk S. Assessment of transition readiness in adolescents in Thailand with rheumatic diseases: a cross-sectional study. Pediatr Rheumatol Online J. 2021;19(1):101. doi: 10.1186/s12969-021-00602-5. DOI: https://doi.org/10.1186/s12969-021-00602-5
Meleis AI. Transitions theory: middle range and situation specific theories in research and practice. New York: Springer Publishing Company; 2010.
Procidano ME, Heller K. Measures of perceived social support from friends and from family: three validation studies. Am J Community Psychol. 1983;11(1):1-24. doi: 10.1007/BF00898416. DOI: https://doi.org/10.1007/BF00898416
Fitzpatrick MM, Anderson AM, Browning C, Ford JL. Relationship between family and friend support and psychological distress in adolescents. J Pediatr Health Care. 2024;38(6):804-11. doi:10.1016/j.pedhc.2024.06.016. DOI: https://doi.org/10.1016/j.pedhc.2024.06.016
Gandhi B, Cheek S, Campo JV. Anxiety in the pediatric medical setting. Child Adolesc Psychiatr Clin N Am. 2012 Jul;21(3):643-53. doi: 10.1016/j.chc.2012.05.013. PMID: 22800999. DOI: https://doi.org/10.1016/j.chc.2012.05.013
Cervin M, Norris LA, Ginsburg G, Gosch EA, Compton SN, Piacentini J, et al. The p factor consistently predicts long-term psychiatric and functional outcomes in anxiety-disordered youth. J Am Acad Child Adolesc Psychiatry. 2021;60(7):902-12. doi: 10.1016/j.jaac.2020.08.440 DOI: https://doi.org/10.1016/j.jaac.2020.08.440
Cao X, Feng M, Ge R, Wen Y, Yang J, Li X. Relationship between self-management of patients with anxiety disorders and their anxiety level and quality of life: a cross-sectional study. PLoS One. 2023;18(5):e0284121. doi:10.1371/journal.pone.0284121 DOI: https://doi.org/10.1371/journal.pone.0284121
Jaworski M, Adamus MM, Bojar J. The sense of responsibility for the health as an important element of health education. Int Acad Conf Hum Soc Cult. 2016. doi: 10.12783/dtssehs/hsc2016/3511. DOI: https://doi.org/10.12783/dtssehs/hsc2016/3511
Björk J, Stenfors T, Juth N, Engström M, Lindberg J. Personal responsibility for health? a phenomenographic analysis of general practitioners’ conceptions. Scand J Prim Health Care. 2021;39(3):322-31. doi: 10.1080/02813432.2021.1935048. DOI: https://doi.org/10.1080/02813432.2021.1935048
Barnett S. Foster care youth and the development of autonomy. Int Rev Psychiatry. 2020;32(3):265-71. doi:10.1080/09540261.2020.1720622. DOI: https://doi.org/10.1080/09540261.2020.1720622
Wongmuan K. Factors predicting transition readiness from pediatric to adult medical care in adolescents with chronic illness [master’s dissertation]. Bangkok: Mahidol University; 2012.
Birmaher B, Khetarpal S, Brent D, Cully M, Balach L, Kaufman J, et al. The screen for child anxiety related emotional disorders (SCARED): scale construction and psychometric characteristics. J Am Acad Child Adolesc Psychiatry. 1997;36(4):545-53. doi: 10.1097/00004583-199704000-00018. DOI: https://doi.org/10.1097/00004583-199704000-00018
Wood DL, Sawicki GS, Miller MD, Smotherman C, Lukens-Bull K, Livingood WC, et al. The transition readiness assessment questionnaire (TRAQ): its factor structure, reliability, and validity. Acad Pediatr. 2014;14(4):415-22. doi: 10.1016/j.acap.2014.03.008. DOI: https://doi.org/10.1016/j.acap.2014.03.008
Baron RM, Kenny DA. The moderator-mediator variable distinction in social psychological research: conceptual, strategic, and statistical considerations. J Pers Soc Psychol. 1986;51:1173-82. DOI: https://doi.org/10.1037//0022-3514.51.6.1173
Badour B, Bull A, Gupta AA, Mirza RM, Klinger CA. Parental involvement in the transition from paediatric to adult care for youth with chronic illness: a scoping review of the North American literature. Int J Pediatr. 2023;2023:9392040. doi:10.1155/2023/9392040 DOI: https://doi.org/10.1155/2023/9392040
Hong HS, Im Y. Factors associated with healthcare transition readiness for adolescents with chronic conditions: a cross-sectional study. J Child Health Care. 2024:13674935241248859. doi: 10.1177/13674935241248859. DOI: https://doi.org/10.1177/13674935241248859
Gumidala AP, Greenley RN, Plevinsky JM, Poulopoulos N, Cabrera J, Lerner D, et al. Moving on: transition readiness in adolescents and young adults with IBD. Inflamm Bowel Dis. 2018;24(3):482-9. doi: 10.1093/ibd/izx051. DOI: https://doi.org/10.1093/ibd/izx051
Ma J, Zhou S, Bai X, Luo D, Zheng Y, Qin Y, et al. Transition readiness of adolescents with cancer: a cross-sectional study based on self-determination theory. Eur J Oncol Nurs. 2024;69:102521. doi: 10.1016/j.ejon.2024.102521. DOI: https://doi.org/10.1016/j.ejon.2024.102521
Kinch M, Kroll T, Buckle N, Somanadhan S. Interventions to support young adults and families with the healthcare transition between paediatric and adult nephrology health services: a systematic scoping review. J Pediatr Nurs. 2024;78:e346-63. doi:10.1016/j.pedn.2024.07.026 DOI: https://doi.org/10.1016/j.pedn.2024.07.026
Zhu Y, Chen Y, Tang Y, Zhang X, Shen Q, Li F, et al. The association between perceived social support and self-management behaviors in adolescents and young adults with inflammatory bowel disease: the chain mediating role of basic psychological needs and anxiety/depression. Front Psychol. 2025;16:1483021. doi:10.3389/fpsyg.2025.1483021 DOI: https://doi.org/10.3389/fpsyg.2025.1483021
Tornivuori A, Kallio M, Culnane E, Peura P, Kosola S, Chaney D, et al. Transition readiness and anxiety among adolescents with a chronic condition and their parents: a cross-sectional international study. J Adv Nurs. 2024;80(2):756-64. doi: 10.1111/jan.15860. DOI: https://doi.org/10.1111/jan.15860
Boland RJ, Verduin ML, Ruiz P. Kaplan & Sadock’s synopsis of psychiatry. 12th ed. Philadelphia: Wolters Kluwer; 2022.
Kwok G, Levonyan-Radloff K, Masterson M, Ohman-Strickland P, Pawlish KS, Burger SS, et al. A randomized feasibility trial of Managing Your Health: a self-management and peer mentoring intervention for young adult survivors of childhood cancer. J Pediatr Psychol. 2025:jsaf004. doi:10.1093/jpepsy/jsaf004 DOI: https://doi.org/10.1093/jpepsy/jsaf004
Zimmerman C, Garland BH, Enzler CJ, Deen D, McGowan K, Dannaway D, et al. The roles of quality of life and family and peer support in feelings about transition to adult care in adolescents with gastroenterology, renal, and rheumatology diseases. J Pediatr Nurs. 2022;62:193-9. doi: 10.1016/j.pedn.2021.04.032. DOI: https://doi.org/10.1016/j.pedn.2021.04.032
Lee CC, Enzler CJ, Garland BH, Zimmerman CJ, Raphael JL, Hergenroeder AC, et al. The development of health self-management among adolescents with chronic conditions: an application of self-determination theory. J Adolesc Health. 2021;68(2):394-402. doi:10.1016/j.jadohealth.2020.05.053 DOI: https://doi.org/10.1016/j.jadohealth.2020.05.053
Carrara FSA, Piotto DGP, Silva II, Len CA, Russo GCS, Chiba SM, et al. Factors related to the readiness of Brazilian chronic pediatric patients to transition to care in adult clinics. J Pediatr (Rio J). 2023;99(3):254-62. doi:10.1016/j.jped.2022.10.006 DOI: https://doi.org/10.1016/j.jped.2022.10.006
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