Scoping Review of Adolescent Autonomy and Responsibility for Managing Chronic Physical Conditions.
Elif Isik, Brittany Haynes, Melanie Morton and 3 others
PMID 42206617WHAT IT FOUND
Adolescents with chronic physical conditions described taking on self-management as uneven: setbacks were more common after premature transfer, illness, or distrust.
Age did not always match readiness, and adolescents reported that direct clinician communication and clear plans increased satisfaction.
Key findings
01The review mapped four themes: transferring and regressing responsibility, communication and support for readiness, emotional turmoil and identity adaptation, and autonomy in action.
02Setbacks in responsibility transfer were more common when transfer was premature, during illness, or when adolescent-parent-provider relationships lacked trust.
03Adolescents reported greater satisfaction when clinicians addressed them directly, maintained face-to-face engagement, and gave clear information about their condition and care plan.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
No critical appraisal or risk-of-bias assessment was conducted, so the quality of the 30 included studies is not graded. The review included mixed qualitative, quantitative, and one mixed-methods studies across many chronic conditions and countries, so it maps perceptions rather than showing which nurse-delivered strategies work best. Most samples were skewed toward older adolescents and only English-language publications were included, so younger adolescents and non-English contexts may be underrepresented. The literature did not consistently define autonomy and responsibility, and many studies did not differentiate between stages of adolescence. Intervention-focused research addressing sustained routines and communication outside clinical encounters was described as limited.
Declared interests
The authors reported no conflicts of interest.
The easy way to misread this
Do not read this as evidence that a specific autonomy-supporting intervention improves self-management. This is a scoping review without quality appraisal, and it maps adolescents' perceptions rather than testing outcomes.