Self-efficacy and Resilience Are Useful Predictors of Transition Readiness Scores in Adolescents with Inflammatory Bowel Diseases

Background: Adolescence is a vulnerable period for those afflicted with inflammatory bowel disease (IBD). There is limited knowledge of factors influencing transition readiness in this population. We sought to determine whether self-efficacy and resilience would be informative predictors of transition readiness independent of age. Methods: Patients with IBD aged 16 to 23 years cared for in a pediatric setting were prospectively enrolled. On entry, patients filled out the Transition Readiness Assessment Questionnaire (TRAQ); IBD Self-Efficacy Scale—Adolescent (IBD-SES-A); and the Connor–Davidson Resilience Scale. Demographic data and disease-specific information were collected from the medical record and by the provider. General linear modeling and autocorrelation were performed to investigate predictors of transition readiness. Results: Eighty-seven patients (62 Crohn's disease and 25 ulcerative colitis) were included, with a median age of 19 years (interquartile range 1–3: 17–20; min–max: 16–23). After controlling for age, the IBD-SES-A predicted TRAQ [F(1) = 11.69, R2 = 0.16, P = 0.001], accounting for 16% of the variance. The Connor–Davidson Resilience Scale also independently predicted TRAQ score [F(1) = 6.45, R2 = 0.09, P = 0.01], accounting for 9% of the variance. The IBD-SES-A and Connor–Davidson Resilience Scale were significantly auto correlated (r = 0.044, P = 0.001); in the final predictive model, only IBD-SES-A was predictive of TRAQ [F(1) = 4.01, R2 = 0.12, P = 0.004]. None of the patients' demographic, disease, or socioeconomic parameters informed transition readiness once self-efficacy and resilience were considered. Conclusions: This is the first study to identify a reliable predictor of transition readiness scores in adolescents with IBD that does not seem to be influenced by age.

[1]  T. Taft,et al.  Validation of a Self-efficacy Scale for Adolescents and Young Adults With Inflammatory Bowel Disease , 2017, Journal of pediatric gastroenterology and nutrition.

[2]  M. Ferris,et al.  Relating Health Locus of Control to Health Care Use, Adherence, and Transition Readiness Among Youths With Chronic Conditions, North Carolina, 2015 , 2016, Preventing chronic disease.

[3]  S. Hanauer,et al.  Integrating Adolescents and Young Adults into Adult-Centered Care for IBD , 2016, Current Gastroenterology Reports.

[4]  M. Dubinsky,et al.  Transition of Inflammatory Bowel Disease Care: Assessment of Transition Readiness Factors and Disease Outcomes in a Young Adult Population , 2016, Inflammatory bowel diseases.

[5]  L. Keefer,et al.  Self-Management Techniques in IBD , 2016 .

[6]  K. Javalkar,et al.  The Relationship of Transition Readiness, Self-Efficacy, and Adherence to Preferred Health Learning Method by Youths with Chronic Conditions. , 2015, Journal of pediatric nursing.

[7]  L. Keefer,et al.  The Emerging Adult with Inflammatory Bowel Disease: Challenges and Recommendations for the Adult Gastroenterologist , 2015, Gastroenterology research and practice.

[8]  L. Denson,et al.  Transition Readiness Skills Acquisition in Adolescents and Young Adults with Inflammatory Bowel Disease: Findings from Integrating Assessment into Clinical Practice , 2015, Inflammatory bowel diseases.

[9]  J. Adler,et al.  Transition Readiness in Pediatric Patients With Inflammatory Bowel Disease: Patient Survey of Self-Management Skills , 2015, Journal of pediatric gastroenterology and nutrition.

[10]  D. Charney,et al.  Psychosocial facets of resilience: implications for preventing posttrauma psychopathology, treating trauma survivors, and enhancing community resilience , 2014, European journal of psychotraumatology.

[11]  W. Livingood,et al.  The Transition Readiness Assessment Questionnaire (TRAQ): its factor structure, reliability, and validity. , 2014, Academic pediatrics.

[12]  L. Keefer,et al.  Development of a Self-Efficacy Scale for Adolescents and Young Adults With Inflammatory Bowel Disease , 2014, Journal of pediatric gastroenterology and nutrition.

[13]  D. Charney,et al.  Resilience and Personality Traits among Living Liver and Kidney Donors , 2014, Progress in transplantation.

[14]  E. Andrews,et al.  Healthcare utilization and comorbidity burden among children and young adults in the United States with systemic lupus erythematosus or inflammatory bowel disease. , 2012, The Journal of pediatrics.

[15]  L. Keefer,et al.  Optimizing Management of Crohn's Disease Within a Project Management Framework: Results of A Pilot Study§ , 2012, Inflammatory bowel diseases.

[16]  T. Taft,et al.  The role of self‐efficacy in inflammatory bowel disease management: Preliminary validation of a disease‐specific measure , 2011, Inflammatory bowel diseases.

[17]  T. Taft,et al.  M1057 The Role of Self-Efficacy in Inflammatory Bowel Disease Management: Validation of a Disease-Specific Measure , 2010 .

[18]  Murray B Stein,et al.  Psychometric analysis and refinement of the Connor-davidson Resilience Scale (CD-RISC): Validation of a 10-item measure of resilience. , 2007, Journal of traumatic stress.

[19]  C. A. Morgan,et al.  Social support and resilience to stress: from neurobiology to clinical practice. , 2007, Psychiatry (Edgmont (Pa. : Township)).

[20]  J. Satsangi,et al.  Toward an integrated clinical, molecular and serological classification of inflammatory bowel disease: report of a Working Party of the 2005 Montreal World Congress of Gastroenterology. , 2005, Canadian journal of gastroenterology = Journal canadien de gastroenterologie.

[21]  R. Gibson,et al.  Health care transition: destinations unknown. , 2002, Pediatrics.

[22]  R. Pounder,et al.  A simple clinical colitis activity index , 1998, Gut.

[23]  R. F. Harvey,et al.  A SIMPLE INDEX OF CROHN'S-DISEASE ACTIVITY , 1980, The Lancet.

[24]  A. Bandura Self-efficacy: toward a unifying theory of behavioral change. , 1977, Psychological review.