Abstract
Background
End-stage renal disease (ESRD) leads to the need for dialysis and renal transplantation (Tx). Peritoneal dialysis (PD) of young children is normally performed at home by the parents and affects the whole family. We studied the coping of families with a young child with ESRD by interviewing the parents of 19 children.
Methods
The spousal and parent–child relationships were assessed by using the Psychosocial Assessment of Childhood Experiences (PACE) and the Brief Measure of Expressed Emotion, respectively. A control group of 22 families with a healthy child was used for the parent–child relationship evaluation.
Results
The spousal relationship at the start of PD was good or fairly good in most of the families and remained good in half of the families following renal Tx. Lack of support from close relatives and renal Tx were associated with a poorer relationship quality. Almost all parents expressed much or fairly much emotional warmth towards the child throughout the study, but there was a trend towards increased criticism over time. No differences in the degree of expressed warmth or criticism were noted between the index parents and controls.
Conclusions
Overall, the study families appeared to cope well despite the serious illness of their child and the demands of the treatments.
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References
Oreopoulos DG, Katirtzoglou A, Arbus G, Cordy P (1979) Dialysis and transplantation in young children. Br Med J 1:1628–1629
Hölttä TM, Rönnholm KA, Jalanko H, Ala-Houhala M, Antikainen M, Holmberg C (1997) Peritoneal dialysis in children under 5 years of age. Perit Dial Int 17:573–580
Shroff R, Ledermann S (2009) Long-term outcome of chronic dialysis in children. Pediatr Nephrol 24:463–474
Groothoff JW (2005) Long-term outcomes of children with end-stage renal disease. Pediatr Nephrol 20:849–853
Herthelius M, Celsi G, Edstrom Halling S, Krmar RT, Sandberg J, Tyden G, Asling-Monemi K, Berg UB (2012) Renal transplantation in infants and small children. Pediatr Nephrol 27:145–150
Qvist E, Krogerus L, Laine J, Jalanko H, Rönnholm K, Salmela K, Sairanen H, Leijala M, Holmberg C (1998) Long-term follow up of renal function and histology after renal allograft transplantation in early childhood. Transplant Int 11[Suppl 1]:S39–S41
Qvist E, Pihko H, Fagerudd P, Valanne L, Lamminranta S, Karikoski J, Sainio K, Rönnholm K, Jalanko H, Holmberg C (2002) Neurodevelopmental outcome in high-risk patients after renal transplantation in early childhood. Pediatr Transplant 6:53–62
Valanne L, Qvist E, Jalanko H, Holmberg C, Pihko H (2004) Neuroradiologic findings in children with renal transplantation under 5 years of age. Pediatr Transplant 8:44–51
Laakkonen H, Lönnqvist T, Valanne L, Karikoski J, Holmberg C, Rönnholm K (2011) Neurological development in 21 children on peritoneal dialysis in infancy. Pediatr Nephrol 26:1863–1871
Bowlby J (1960) Grief and mourning in infancy and early childhood. Psychoanalytical study of the child. International Universities Press, New York
Wallander JL, Varni JW (1998) Effects of pediatric chronic physical disorders on child and family adjustment. J Child Psychol Psychiatry 39:29–46
Knez R, Franciskovic T, Samarin RM, Niksic M (2011) Parental quality of life in the framework of paediatric chronic gastrointestinal disease. Coll Antropol 35[Suppl 2]:275–280
Goldberg S, Washington J, Morris P, Fischer-Fay A, Simmons RJ (1990) Early diagnosed chronic illness and mother-child relationships in the first two years. Can J Psychiatry 35:726–733
Van Horn M, DeMaso DR, Gonzalez-Heydrich J, Erickson JD (2001) Illness-related concerns of mothers of children with congenital heart disease. J Am Acad Child Adolesc Psychiatry 40:847–854
Visconti KJ, Saudino KJ, Rappaport LA, Newburger JW, Bellinger DC (2002) Influence of parental stress and social support on the behavioral adjustment of children with transposition of the great arteries. J Dev Behav Pediatr 23:314–321
Hilliard ME, Monaghan M, Cogen FR, Streisand R (2011) Parent stress and child behaviour among young children with type 1 diabetes. Child Care Health Dev 37:224–232
Taft TH, Ballou S, Keefer L (2012) Preliminary evaluation of maternal caregiver stress in pediatric eosinophilic gastrointestinal disorders. J Pediatr Psychol 37:523–532
Tak YR, McCubbin M (2002) Family stress, perceived social support and coping following the diagnosis of a child’s congenital heart disease. J Adv Nurs 39:190–198
Bowlby J (1969) Attachment and loss, vol. 1: attachment. Basic Books, New York
Goldberg S (1988) Risk factors in infant-mother attachment. Can J Psychol 42:173–188
Pyhälä R, Räikkönen K, Pesonen AK, Heinonen K, Lahti J, Hovi P, Strang-Karlsson S, Andersson S, Eriksson JG, Järvenpää AL, Kajantie E (2011) Parental bonding after preterm birth: Child and parent perspectives in the Helsinki study of very low birth weight adults. J Pediatr 158:251–6.e1
Holmberg C, Antikainen M, Rönnholm K, Ala Houhala M, Jalanko H (1995) Management of congenital nephrotic syndrome of the Finnish type. Pediatr Nephrol 9:87–93
Holmberg C, Tryggvason K, Kestilä M, Jalanko H (2004) Congenital nephrotic syndrome. In: Avner E, Harmon W, Niaudet P (eds) Pediatric nephrology, 5th edn. Lippincott Williams & Wilkins, Philadelphia, pp 523–532
Watson AR (1995) Strategies to support families of children with end-stage renal failure. Pediatr Nephrol 9:628–631
Watson AR (1996) Home health and respite care. Perit Dial Int 16[Suppl 1]:S551–S553
Sandberg S, Rutter M, Giles S, Owen A (1993) Assessment of psychosocial experiences in childhood: methodological issues and some illustrative findings. J Child Psychol Psychiatry 34:879–897
Glen S, Simpson A, Drinnan D, McGuinness D, Sandberg S (1993) Testing the reliability of a new measure of life events and experiences in childhood: the psychosocial assessment of childhood experiences (PACE). Eur Child Adolesc Psychiatry 2:98–110
Sandberg S, Rutter M, Järvi J (2003) Brief measure of expressed emotion: internal consistency and stability over time. Int J Methods Psychiatr Res 12:182–191
Sarason IG, Johnson JH, Siegel JM (1978) Assessing the impact of life changes: development of the life experiences survey. J Consult Clin Psychol 46:932–946
Official Statistics of Finland (OSF) (2012) Classification of education, levels of education (homepage on the Internet). OSF, Helsinki. Available at: http://www.stat.fi/meta/luokitukset/koulutusaste/001-2010/index_en.html. Accessed 28 Feb 2012
Official Statistics of Finland (OSF) (2012) Classification of occupations 2001 (homepage on the Internet). OSF, Helsinki. Available at: http://www.stat.fi/meta/luokitukset/ammatti/001-2001/index_en.html. Accessed 28 Feb 2012
Aldridge MD (2008) How do families adjust to having a child with chronic kidney failure? A systematic review. Nephrol Nurs J 35:157–162
Tsai TC, Liu SI, Tsai JD, Chou LH (2006) Psychosocial effects on caregivers for children on chronic peritoneal dialysis. Kidney Int 70:1983–1987
Tong A, Lowe A, Sainsbury P, Craig JC (2010) Parental perspectives on caring for a child with chronic kidney disease: an in-depth interview study. Child Care Health Dev 36:549–557
Ahlborg T, Misvaer N, Moller A (2009) Perception of marital quality by parents with small children: a follow-up study when the firstborn is 4 years old. J Fam Nurs 15:237–263
Malinen K, Kinnunen U, Tolvanen A, Ronka A, WierdaBoer H, Gerris J (2010) Happy spouses, happy parents? Family relationships among Finnish and Dutch dual earners. J Marriage Fam 72:293–306
Barry RA, Kochanska G (2010) A longitudinal investigation of the affective environment in families with young children: from infancy to early school age. Emotion 10:237–249
Diseth TH, Tangeraas T, Reinfjell T, Bjerre A (2011) Kidney transplantation in childhood: mental health and quality of life of children and caregivers. Pediatr Nephrol 26:1881–1892
Park KS, Hwang YJ, Cho MH, Ko CW, Ha IS, Kang HG, Cheong HI, Park YS, Lee YJ, Lee JH, Cho HY (2012) Quality of life in children with end-stage renal disease based on a PedsQL ESRD module. Pediatr Nephrol 27:2293–2300
Goldstein SL, Graham N, Burwinkle T, Warady B, Farrah R, Varni JW (2006) Health-related quality of life in pediatric patients with ESRD. Pediatr Nephrol 21:846–850
Groothoff JW, Grootenhuis MA, Offringa M, Stronks K, Hutten GJ, Heymans HS (2005) Social consequences in adult life of end-stage renal disease in childhood. J Pediatr 146:512–517
Garralda ME, Jameson RA, Reynolds JM, Postlethwaite RJ (1988) Psychiatric adjustment in children with chronic renal failure. J Child Psychol Psychiatry 29:79–90
Haavisto A, Jalanko H, Sintonen H, Holmberg C, Qvist E (2011) Quality of life in adult survivors of pediatric kidney transplantation. Transplantation 92:1322–1326
Qvist E, Närhi V, Apajasalo M, Rönnholm K, Jalanko H, Almqvist F, Holmberg C (2004) Psychosocial adjustment and quality of life after renal transplantation in early childhood. Pediatr Transplant 8:120–125
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Laakkonen, H., Taskinen, S., Rönnholm, K. et al. Parent–child and spousal relationships in families with a young child with end-stage renal disease. Pediatr Nephrol 29, 289–295 (2014). https://doi.org/10.1007/s00467-013-2618-1
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DOI: https://doi.org/10.1007/s00467-013-2618-1