Abstract
BACKGROUND: 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. METHODS: 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. RESULTS: 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. CONCLUSIONS: 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.