Determinants of transition readiness among adolescent and young adult survivors of childhood cancer: a systematic review.
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PURPOSE: Adolescent and young adult (AYA) survivors of childhood cancer face complex challenges during the transition to adult-oriented cancer care, highlighting the importance of identifying facilitators and inhibitors of transition readiness. This study aimed to identify the determinants of transition readiness among AYA survivors of childhood cancer. METHODS: This study employed a systematic review following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Literature searches were conducted in MEDLINE, Scopus, CINAHL, ScienceDirect, and Wiley between December 15 and 31, 2025. Eligible studies were full-text English-language articles published between January 2015 and December 2025 that involved AYA childhood cancer survivors aged 15-39 years. Data were synthesized narratively using an inductive approach to identify key themes within the framework of Meleis' Transition Theory. RESULTS: A total of 17 studies from eight countries were included. Determinants of transition readiness were grouped into three transition conditions: personal, community, and societal factors. Personal factors included beliefs and attitudes, socioeconomic status, preparation and knowledge, mental and psychological health, and clinical and sociodemographic characteristics. Community factors included relationships with healthcare providers, family and peer support, communication and shared decision-making, and community resources and services. Societal factors reflected the influence of the healthcare system, continuity and coordination of care, policy and insurance, and geographic context. CONCLUSION: Transition readiness is shaped by multidimensional determinants that interact at the personal, community, and societal levels. IMPLICATIONS FOR CANCER SURVIVORS: These findings underscore the need for a multidimensional, integrated approach to planning and implementing healthcare transitions from pediatric to adult care for AYA survivors of childhood cancer. They highlight key factors influencing transition readiness. For healthcare professionals, these findings provide an evidence-based foundation to deliver comprehensive, age-appropriate transitional care. For researchers, this synthesis identifies critical knowledge gaps, refines theoretical and measurement frameworks, and guides the development and evaluation of targeted transition interventions.