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
Affiliations: University of North Carolina-Chapel Hill, Chapel Hill,
NC, USA | Department of Pediatrics, University of North Carolina
School of Medicine, Chapel Hill, NC, USA | School of Medicine, East Carolina University,
Greenville, NC, USA | Departments of Allied Health Sciences and Psychiatry
University of North Carolina School of Medicine, Chapel Hill, NC, USA
Note: [] Corresponding author: Maria Ferris, Division of Pediatric
Nephrology, Department of Medicine and Pediatrics, University of North Carolina
School of Medicine CB# 7155, Chapel Hill, NC 27599-7155, USA. Tel.: +1 919
66 2561, Ext 237; E-mail: [email protected]
Abstract: PURPOSE: 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. CONCLUSION: 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.
