Self-Esteem, Independent Consciousness, and Transition Readiness in Adolescents With Childhood-Onset Chronic Diseases

Objective: Adolescent patients with childhood-onset chronic diseases not only face physical, mental, and social challenges but also developmental challenges with respect to becoming independent from their parents. Elucidating the psychological mechanisms underlying transition readiness could aid in the development of effective psychological interventions for patients with childhood-onset chronic diseases to prepare them for transition to adulthood, leading to their successful transfer to adult healthcare systems. Self-esteem has been demonstrated to be relatively lower in adolescents with childhood-onset chronic diseases compared to their healthy peers. However, an independent consciousness—comprising self-independence, dependence on parents, and rebellion and internal confusion—can be an important psychological factor in improving the transition readiness of these patients. Thus, this study examined the relationships between self-esteem, independent consciousness, and transition readiness among adolescents with childhood-onset chronic diseases. Methods: We conducted a secondary analysis of cross-sectional data on 125 adolescents with childhood-onset chronic diseases from a study that developed the Japanese version of the TRANSITION-Q. We examined the relationships between self-esteem, independent consciousness, and transition readiness using structural equation modeling and bias-corrected bootstrapping to test their direct and indirect effects. Results: The relationship between self-esteem and transition readiness was completely mediated by independent consciousness. The findings emphasize the importance of interventions that enhance independent consciousness among adolescents with childhood-onset chronic diseases, especially those with low self-esteem, to increase their transition readiness and promote a smooth transition to adult health care. Conclusions: These findings could help improve support strategies in transitional care for adolescents with childhood-onset chronic diseases.