Purpose:  This study explored, examined and determined the relationships between self-confidence, problem-solving ability, coping patterns, symptom severity, and preferences for involvement among chronically ill adolescents. Involvement of chronically ill adolescents enhances their decisional capacity beyond their adolescent years.

Methods: Descriptive, inferential analysis and grounded theory examined and determined the preferences of chronically ill adolescents. Correlations determined relationships, and multiple regressions examined predictive associations between self-confidence, problem solving ability, coping patterns, symptom severity, and preferences for involvement in health decisions. ANOVAs examined differences in the preferences for involvement in relation to who should decide treatment options and who decides acceptability of risks/benefits of  options. Grounded theory tradition unfolded core perspectives showing associations with empirical findings.Results:     Empirical findings revealed chronically ill adolescents’ desire for equal participation when deciding for acceptability of risks and benefits of treatment options. Self-confidence, problem solving ability, symptom severity, age, gender and diagnosis did not show significant relationships with preferences for involvement. Coping ability emerged over time with the experience of chronic illness. Themes emerged, being heard, being informed, being involved, and having a voice unfolded seeking for involvement   as a core perspective using open,  axial, and selective coding of chronically ill adolescent’s narrative responses.

Implications:               Results imply that whether adolescents have chronic illnesses or not they desire to have their voices heard as an equal in decisions affecting them. They are saying, “I suffer the consequences of decisions affecting myself, therefore, I have  the right to have an equal voice” in a collaborative relationship.

Application:                 Involving chronically ill adolescents in health treatment decisions affect a shift in health policy, and adolescent health care. Implementing these findings in adolescent health care is a new approach important for evidence-based practice.

Key Words:        Preferences, decision-making, and self-actualization.