Transition Readiness in Adolescents and Young Adults with Type 1 Diabetes Mellitus: A Concept Analysis

The transition from pediatric to adult healthcare is a critical and vulnerable period for adolescents and young adults with type 1 diabetes, often associated with increased risks of acute complications and long-term adverse outcomes. Despite its recognized clinical importance, the concept of "transition readiness" remains inconsistently defined and operationalized in research and practice. This study aimed to clarify the concept using Walker and Avant's method of concept analysis.

A comprehensive literature search was conducted across multiple databases, complemented by reference screening and a targeted Google search for dictionary definitions, and documented using the PRISMA 2020 flow diagram.

Forty-two papers met the inclusion criteria and were analyzed to identify defining attributes, antecedents, consequences, and empirical referents of transition readiness. Four defining attributes emerged: multidimensional maturity; diabetes knowledge and health literacy; self-management competencies; and healthcare system navigation skills. Antecedents included developmental maturation, a gradual shift from parent-led to autonomous care, and engagement in structured transition pathways. Consequences were identified at patient, care-process, and health-system levels, highlighting potential improvements in clinical outcomes and continuity of care. Empirical referents mainly consisted of diabetes-specific readiness tools, though psychometric limitations persist.

Transition readiness appears as a multidimensional, measurable, and actionable construct that promotes safer, higher‑quality transitional diabetes care. A clearer conceptualization of transition readiness can support healthcare professionals in identifying adolescents' preparedness for transfer and planning individualized, developmentally appropriate interventions. Standardized assessment of readiness may improve continuity of care, reduce transition-related risks, and strengthen patient engagement in self-management.