1
|
Hudson AC, van Zwieten A, Mallitt KA, Durkan A, Hahn D, Guha C, Khalid R, Didsbury M, Francis A, McTaggart S, Mackie FE, Prestidge C, Teixeira-Pinto A, Lah S, Howell M, Howard K, Nassar N, Jaure A, Craig JC, Wong G, Kim S. School attendance and sport participation amongst children with chronic kidney disease: a cross-sectional analysis from the Kids with CKD (KCAD) study. Pediatr Nephrol 2024; 39:1229-1237. [PMID: 37945915 PMCID: PMC10899305 DOI: 10.1007/s00467-023-06198-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Revised: 10/05/2023] [Accepted: 10/06/2023] [Indexed: 11/12/2023]
Abstract
BACKGROUND School attendance and life participation, particularly sport, is a high priority for children with chronic kidney disease (CKD). This study is aimed at assessing the association between CKD stage, sports participation, and school absences in children with CKD. METHODS Using data from the binational Kids with CKD study (ages 6-18 years, n = 377), we performed multivariable regression to evaluate the association between CKD stage, school absences, and sports participation. RESULTS Overall, 62% of participants played sport with the most frequent sport activities engaged in being swimming (17%) and soccer (17%). Compared to children with CKD 1-2, the incidence rate ratios (IRR) (95% CI) for sports participation amongst children with CKD 3-5, dialysis, or transplant were 0.84 (0.64-1.09), 0.59 (0.39-0.90), and 0.75 (0.58-0.96), respectively. The median (IQR) days of school absences within a four-week period were 1 day (0-1), with children on dialysis reporting the highest number of school absences (9 days (5-15)), followed by transplant recipients (2 days (1-7)), children with CKD 3-5 (1 day (0-3)), and with CKD 1-2 (1 day (0-3)). Duration of CKD modified the association between CKD stage and school absences, with children with a transplant experiencing a higher number of missed school days with increasing duration of CKD, but not in children with CKD 1-5 or on dialysis (p-interaction < 0.01). CONCLUSIONS Children receiving dialysis and with a kidney transplant had greater school absences and played fewer sports compared to children with CKD stages 1-2. Innovative strategies to improve school attendance and sport participation are needed to improve life participation of children with CKD.
Collapse
Affiliation(s)
- Adam C Hudson
- Centre for Kidney Research, The Children's Hospital at Westmead, Cnr Hainsworth St and Hawkesbury Road, Westmead, NSW, 2145, Australia
- Sydney School of Public Health, The University of Sydney, Sydney, Australia
| | - Anita van Zwieten
- Centre for Kidney Research, The Children's Hospital at Westmead, Cnr Hainsworth St and Hawkesbury Road, Westmead, NSW, 2145, Australia
- Sydney School of Public Health, The University of Sydney, Sydney, Australia
| | - Kylie-Ann Mallitt
- Centre for Kidney Research, The Children's Hospital at Westmead, Cnr Hainsworth St and Hawkesbury Road, Westmead, NSW, 2145, Australia
- Sydney School of Public Health, The University of Sydney, Sydney, Australia
| | - Anne Durkan
- Centre for Kidney Research, The Children's Hospital at Westmead, Cnr Hainsworth St and Hawkesbury Road, Westmead, NSW, 2145, Australia
- Department of Nephrology, The Children's Hospital at Westmead, Westmead, Australia
| | - Deirdre Hahn
- Centre for Kidney Research, The Children's Hospital at Westmead, Cnr Hainsworth St and Hawkesbury Road, Westmead, NSW, 2145, Australia
- Department of Nephrology, The Children's Hospital at Westmead, Westmead, Australia
| | - Chandana Guha
- Centre for Kidney Research, The Children's Hospital at Westmead, Cnr Hainsworth St and Hawkesbury Road, Westmead, NSW, 2145, Australia
- Sydney School of Public Health, The University of Sydney, Sydney, Australia
| | - Rabia Khalid
- Centre for Kidney Research, The Children's Hospital at Westmead, Cnr Hainsworth St and Hawkesbury Road, Westmead, NSW, 2145, Australia
- Sydney School of Public Health, The University of Sydney, Sydney, Australia
| | - Madeleine Didsbury
- Centre for Kidney Research, The Children's Hospital at Westmead, Cnr Hainsworth St and Hawkesbury Road, Westmead, NSW, 2145, Australia
- Sydney School of Public Health, The University of Sydney, Sydney, Australia
| | - Anna Francis
- Centre for Kidney Research, The Children's Hospital at Westmead, Cnr Hainsworth St and Hawkesbury Road, Westmead, NSW, 2145, Australia
- Sydney School of Public Health, The University of Sydney, Sydney, Australia
- Child & Adolescent Renal Service, Queensland Children's Hospital, Brisbane, Australia
| | - Steven McTaggart
- Child & Adolescent Renal Service, Queensland Children's Hospital, Brisbane, Australia
| | - Fiona E Mackie
- Department of Nephrology, Sydney Children's Hospital at Randwick, Sydney, Australia
| | - Chanel Prestidge
- Department of Nephrology, Starship Children's Hospital, Auckland, New Zealand
| | - Armando Teixeira-Pinto
- Centre for Kidney Research, The Children's Hospital at Westmead, Cnr Hainsworth St and Hawkesbury Road, Westmead, NSW, 2145, Australia
- Sydney School of Public Health, The University of Sydney, Sydney, Australia
| | - Suncica Lah
- School of Psychology, The University of Sydney, Sydney, Australia
| | - Martin Howell
- Centre for Kidney Research, The Children's Hospital at Westmead, Cnr Hainsworth St and Hawkesbury Road, Westmead, NSW, 2145, Australia
- Sydney School of Public Health, The University of Sydney, Sydney, Australia
- Menzies Centre for Health Policy and Economics, Faculty of Medicine and Health, University of Sydney, Sydney, Australia
| | - Kirsten Howard
- Sydney School of Public Health, The University of Sydney, Sydney, Australia
- Menzies Centre for Health Policy and Economics, Faculty of Medicine and Health, University of Sydney, Sydney, Australia
| | - Natasha Nassar
- Child Population and Translational Health Research, Children's Hospital at Westmead Clinical School, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Allison Jaure
- Centre for Kidney Research, The Children's Hospital at Westmead, Cnr Hainsworth St and Hawkesbury Road, Westmead, NSW, 2145, Australia
- Sydney School of Public Health, The University of Sydney, Sydney, Australia
| | - Jonathan C Craig
- College of Medicine and Public Health, Flinders University, Adelaide, Australia
| | - Germaine Wong
- Centre for Kidney Research, The Children's Hospital at Westmead, Cnr Hainsworth St and Hawkesbury Road, Westmead, NSW, 2145, Australia
- Sydney School of Public Health, The University of Sydney, Sydney, Australia
- Centre for Transplant and Renal Research, Westmead Hospital, Sydney, Australia
| | - Siah Kim
- Centre for Kidney Research, The Children's Hospital at Westmead, Cnr Hainsworth St and Hawkesbury Road, Westmead, NSW, 2145, Australia.
- Sydney School of Public Health, The University of Sydney, Sydney, Australia.
| |
Collapse
|
2
|
Paterson C, Turner M, Hooper ME, Ladbrook E, Macauley L, McKie A. Identifying experiences of supportive care of children and young people affected by kidney failure: A qualitative systematic review. J Ren Care 2023. [PMID: 38116998 DOI: 10.1111/jorc.12484] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2023] [Revised: 11/03/2023] [Accepted: 11/19/2023] [Indexed: 12/21/2023]
Abstract
BACKGROUND Children and young people affected by kidney failure experience complexities in their care. Little is known about the unique needs of this young patient population group living with a long-term condition. OBJECTIVE A meta-aggregation of all qualitative studies was conducted to identify experiences of supportive care among children and young people living with kidney failure. METHODS A systematic review of qualitative studies was conducted following the Joanna Briggs Institute meta-aggregation method. This review has been reported according to the PRISMA statement guidelines. Six electronic databases (CINAHL, Cochrane Library, MEDLINE, Proquest, PsycINFO, and Scopus) were comprehensively searched by an expert systematic review librarian using keywords and subject headings, from inception to September 2022. All studies were accessed using a predetermined inclusion and exclusion criteria. Methodological quality assessment and data extraction performed. Qualitative findings accompanied by illustrative quotes from included studies were extracted and grouped into categories which created the overall synthesised findings. RESULTS A total of 34 studies were included in this review representing a total of 613 children and young people affected by kidney failure. There was a total of 190 findings which created 13 categories representing experiences of supportive care. The meta-aggregation developed five synthesised findings namely: 'physical needs', 'information and technology', 'treatment and healthcare', 'social needs' and 'psychological impacts'. CONCLUSION This systematic review identified that children and young people affected by kidney failure can experience a range of unmet supportive care needs in routine clinical services. Kidney failure impacted children and young people's self-identify, social and peer networks, introduced daily practical needs because of inherent physical and psychological burden due to the failure and associated treatments. Despite improvements in the medical management of kidney failure in children and young people, further attention is needed to optimise supported self-management in this young patient group.
Collapse
Affiliation(s)
- C Paterson
- Caring Futures Institute, Flinders University, Adelaide, Australia
- Central Adelaide Local Health Network, Adelaide, Australia
- Faculty of Health, University of Canberra, Bruce, Australian Capital Territory, Australia
- Robert Gordon University, Aberdeen, UK
| | - M Turner
- Faculty of Health, University of Canberra, Bruce, Australian Capital Territory, Australia
| | - M-E Hooper
- Faculty of Health, University of Canberra, Bruce, Australian Capital Territory, Australia
| | - E Ladbrook
- Faculty of Health, University of Canberra, Bruce, Australian Capital Territory, Australia
| | | | - A McKie
- Faculty of Health, University of Canberra, Bruce, Australian Capital Territory, Australia
| |
Collapse
|
3
|
Kim S, Van Zwieten A, Lorenzo J, Khalid R, Lah S, Chen K, Didsbury M, Francis A, Mctaggart S, Walker A, Mackie FE, Prestidge C, Teixeira-Pinto A, Tong A, Blazek K, Barton B, Craig JC, Wong G. Cognitive and academic outcomes in children with chronic kidney disease. Pediatr Nephrol 2022; 37:2715-2724. [PMID: 35243536 PMCID: PMC9489550 DOI: 10.1007/s00467-022-05499-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2021] [Revised: 01/31/2022] [Accepted: 02/01/2022] [Indexed: 11/12/2022]
Abstract
BACKGROUND Few data exist on the cognitive and academic functioning of children with chronic kidney disease (CKD) over the trajectory of their illness. We aimed to determine the association between CKD stages and cognitive and academic performance in children over time. METHODS We included 53 participants (aged 6-18 years) with CKD stages 1-5 (n = 37), on dialysis (n = 3), or with functioning kidney transplant (n = 22) from three units in Australia from 2015 to 2019. Participants undertook a series of psychometric tests and were invited for repeated assessments annually. We used linear regression and linear mixed models to investigate the effect of CKD stage, adjusted for socioeconomic status. RESULTS At baseline, full-scale intelligence quotient (FSIQ) (95%CI) of children on kidney replacement therapy (KRT) was in the low average range (87: 78, 96) and average (101: 95, 108) for children with CKD 1-5. Mean (95%CI) FSIQ, word reading, numerical operations, and spelling scores for children on KRT were 14.3 (- 25.3, - 3.3), 11 (- 18.5, - 3.6), 8.5 (- 17.6, 0.76), and 10 (- 18.6, - 1.3) points lower than children with CKD Stages 1-5. Spelling and numerical operations scores declined by 0.7 (- 1.4, - 0.1) and 1.0 (- 2.0, 0.2) units per year increase in age, regardless of CKD stage. CONCLUSIONS Children treated with KRT have low average cognitive abilities and lower academic performance for numeracy and literacy compared to both children with CKD 1-5 and to the general population. However, the rate of decline in academic performance over time is similar for children across the full spectrum of CKD. A higher resolution version of the Graphical abstract is available as Supplementary information.
Collapse
Affiliation(s)
- Siah Kim
- Centre for Kidney Research, The Children's Hospital at Westmead, Sydney, Australia. .,Sydney School of Public Health, The University of Sydney, Sydney, Australia.
| | - Anita Van Zwieten
- grid.413973.b0000 0000 9690 854XCentre for Kidney Research, The Children’s Hospital at Westmead, Sydney, Australia ,grid.1013.30000 0004 1936 834XSydney School of Public Health, The University of Sydney, Sydney, Australia
| | - Jennifer Lorenzo
- grid.413973.b0000 0000 9690 854XKids Neuroscience Centre, The Children’s Hospital at Westmead, Sydney, Australia
| | - Rabia Khalid
- grid.413973.b0000 0000 9690 854XCentre for Kidney Research, The Children’s Hospital at Westmead, Sydney, Australia ,grid.1013.30000 0004 1936 834XSydney School of Public Health, The University of Sydney, Sydney, Australia
| | - Suncica Lah
- grid.1013.30000 0004 1936 834XSchool of Psychology, The University of Sydney, Sydney, Australia
| | - Kerry Chen
- grid.413973.b0000 0000 9690 854XCentre for Kidney Research, The Children’s Hospital at Westmead, Sydney, Australia ,grid.1013.30000 0004 1936 834XSydney School of Public Health, The University of Sydney, Sydney, Australia
| | - Madeleine Didsbury
- grid.413973.b0000 0000 9690 854XCentre for Kidney Research, The Children’s Hospital at Westmead, Sydney, Australia ,grid.1013.30000 0004 1936 834XSydney School of Public Health, The University of Sydney, Sydney, Australia
| | - Anna Francis
- grid.413973.b0000 0000 9690 854XCentre for Kidney Research, The Children’s Hospital at Westmead, Sydney, Australia ,grid.1013.30000 0004 1936 834XSydney School of Public Health, The University of Sydney, Sydney, Australia ,grid.240562.7Child & Adolescent Renal Service, Queensland Children’s Hospital, Brisbane, Australia
| | - Steven Mctaggart
- grid.240562.7Child & Adolescent Renal Service, Queensland Children’s Hospital, Brisbane, Australia
| | - Amanda Walker
- grid.416107.50000 0004 0614 0346Department of Renal Medicine, The Royal Children’s Hospital, Melbourne, Australia
| | - Fiona E. Mackie
- grid.414009.80000 0001 1282 788XDepartment of Nephrology, Sydney Children’s Hospital at Randwick, Sydney, Australia ,grid.1005.40000 0004 4902 0432School of Women’s and Child Health, University of New South Wales, Sydney, Australia
| | - Chanel Prestidge
- grid.414054.00000 0000 9567 6206Department of Nephrology, Starship Children’s Hospital, Auckland, New Zealand
| | - Armando Teixeira-Pinto
- grid.413973.b0000 0000 9690 854XCentre for Kidney Research, The Children’s Hospital at Westmead, Sydney, Australia ,grid.1013.30000 0004 1936 834XSydney School of Public Health, The University of Sydney, Sydney, Australia
| | - Allison Tong
- grid.413973.b0000 0000 9690 854XCentre for Kidney Research, The Children’s Hospital at Westmead, Sydney, Australia ,grid.1013.30000 0004 1936 834XSydney School of Public Health, The University of Sydney, Sydney, Australia
| | - Katrina Blazek
- grid.413973.b0000 0000 9690 854XCentre for Kidney Research, The Children’s Hospital at Westmead, Sydney, Australia ,grid.1013.30000 0004 1936 834XSydney School of Public Health, The University of Sydney, Sydney, Australia
| | - Belinda Barton
- grid.413973.b0000 0000 9690 854XChildren’s Hospital Education Research Institute, The Children’s Hospital at Westmead, Sydney, Australia
| | - Jonathan C. Craig
- grid.413973.b0000 0000 9690 854XCentre for Kidney Research, The Children’s Hospital at Westmead, Sydney, Australia ,grid.1014.40000 0004 0367 2697College of Medicine and Public Health, Flinders University, Adelaide, Australia
| | - Germaine Wong
- grid.413973.b0000 0000 9690 854XCentre for Kidney Research, The Children’s Hospital at Westmead, Sydney, Australia ,grid.1013.30000 0004 1936 834XSydney School of Public Health, The University of Sydney, Sydney, Australia ,grid.413252.30000 0001 0180 6477Centre for Transplant and Renal Research, Westmead Hospital, Sydney, Australia
| |
Collapse
|
4
|
Poursanidou K, Garner P, Watson A. Hospital--school liaison: perspectives of health and education professionals supporting children with renal transplants. J Child Health Care 2008; 12:253-67. [PMID: 19052185 DOI: 10.1177/1367493508096201] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
This article explores collaboration between health and education staff as a key aspect of educational provision for children with chronic medical conditions, drawing upon material from interviews with eight health professionals (paediatric nephrologists and specialist renal nurses) and 11 mainstream schoolteachers involved in the care and schooling of children with renal transplants. Notwithstanding the apparent existence of good practice, a complex interplay of attitudinal, institutional and wider political and economic factors is identified that is likely to undermine the effectiveness of collaboration between health and education professionals. The importance of hospital-school liaison - that is, of a proactive, preventative and hence systematic and strategic nature - is highlighted. Such findings have a particular relevance for policy and practice in the context of the current Every Child Matters agenda, and are likely to have wider applicability to the education of chronically-ill children at large.
Collapse
Affiliation(s)
- Konstantina Poursanidou
- Psychosocial Research Unit, Lancashire School of Health and Postgraduate Medicine, University of Central Lancashire, UK.
| | | | | |
Collapse
|
5
|
Abstract
Pediatric cardiac transplant has become increasingly frequent in the last decade and survival rates have improved remarkably. Outcome research on this population suggests that the majority of children have the capacity for healthy adaptation although 25-40% have been shown to have some type of psychiatric difficulties. As school plays a major role in these children's lives, early intervention and close liaison with schools is indicated to reduce psychological morbidity, enhance adaptation within the school environment and enhance overall adjustment. This paper proposes a model for a school re-entry program for this population. The school re-entry program is aimed at children who are undergoing cardiac transplant and will be entering or re-entering the school system. They may range in academic age from preschool to college level and have been attending private or public schools with placements in regular education programs, regular education programs with resource support, special education programs, and alternative school programs. Others may not have been attending school because of the severity of their medical condition and have been receiving in-home tutoring. Each child is offered school re-entry assistance by a multi-disciplinary team composed of members from the Cardiology Transplant Service. The re-entry program includes cognitive and psychosocial assessment, liaison with the child's school pre- and post-transplant, academic planning and provision of academic, emotional, and behavioral support before, during, and immediately after transplant, a school re-entry visit, and an ongoing school consultation. The goal is to address issues necessary for a successful school re-entry including appropriate academic placement and support, psychosocial adjustment, education of school personnel and ongoing health needs of the student. The next step is to formally evaluate the efficacy of this program in successful school re-entry.
Collapse
Affiliation(s)
- Constance M Weil
- Department of Child and Adolescent Psychiatry, Children's Memorial Hospital, Chicago, IL 60614, USA.
| | | | | |
Collapse
|
6
|
Olausson B, Utbult Y, Hansson S, Krantz M, Brydolf M, Lindström B, Holmgren D. Transplanted children's experiences of daily living: children's narratives about their lives following transplantation. Pediatr Transplant 2006; 10:575-85. [PMID: 16856994 DOI: 10.1111/j.1399-3046.2006.00525.x] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Transplantation is often an appropriate choice of treatment for children with end-stage renal, liver, heart or lung disease. Over the last decade, mortality and morbidity figures have been relatively stable and quality of life fairly good in children who have undergone organ transplantation. Few studies however, have focused on the experiences of transplantation from the child's perspective. The child's view is an important factor when evaluating the 'true' outcome and quality of life after transplantation. The aim of the present study was to illuminate the meaning of transplanted children's experiences of daily living. Unstructured interviews were carried out with 18 children and adolescents, aged 4-18 yr, who had undergone organ transplantation. Their narratives were transcribed and interpreted using a phenomenologic-hermeneutic method inspired by the philosophy of Ricoeur. Two main themes emerged: Being satisfied with life, with the themes: being able to live a normal life; someone who cares; coping with one's new life; and being dissatisfied with life, with the themes: not being able to live a normal life; lacking someone who cares; not being respected; existential thoughts. Most of the children and adolescents were of the opinion that they lived a normal life while the rest strived to achieve a normal life. Social support and mental support were of great importance and, when lacking, had negative consequences. Multi-disciplinary co-operation between healthcare professionals and between the healthcare system, the school and the family is crucial in order to optimize the outcome and quality of life after organ transplantation in children.
Collapse
Affiliation(s)
- B Olausson
- Department of Transplantation and Liver Surgery, Sahlgrenska University Hospital, Göteborg, Sweden
| | | | | | | | | | | | | |
Collapse
|
7
|
Darbyshire P, Oster C, Henning P. Children's and young people's experiences of chronic renal disease: a review of the literature, methodological commentary and an alternative proposal. J Clin Nurs 2006; 15:751-60. [PMID: 16684171 DOI: 10.1111/j.1365-2702.2006.01510.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
AIM The aims of this paper were to review and critique existing research literature on children's and young people's experiences of chronic renal disease and to propose alternative approaches that may be more fruitful in addressing existing research shortcomings. BACKGROUND Chronic renal disease, which results in approximately 1.6-4 new cases per year per million population in the 0-15 years age group, is a serious illness that causes severe and irreversible reduction in kidney function. Despite modern medical advances, its significance and implications for the lives of the children and young people concerned are profound. METHOD Salient literature for this review was obtained using the major health and social science electronic databases such as Medline, CINAHL, Psyclit and Sociofile. Manual searching of relevant books, journals and 'grey literature', combined with the genealogy approach, extended and strengthened the search. CONCLUSIONS Research in this area focuses mainly on two areas, namely psychological adjustment and adaptation to end-stage renal disease. This research is grounded within a framework of empirical psychology that values objectivity, measurement and quantification. This predominantly psychometric approach is critiqued for simplifying the complex experience of end-stage renal disease and for pathologizing children and young people with this disease. We identify a significant gap in the research literature, namely the lack of research that takes into account these children's and young peoples'own perspectives of their experiences. RELEVANCE TO CLINICAL PRACTICE Chronic renal disease has a significant impact on children's and young people's lives. Understanding the experiences of these children is important for the provision of effective healthcare. Conducting child-centred qualitative research in this area would allow us to explore vital questions of meaning, perception and understanding. If health and social care organizations claim to provide 'consumer-focused' services, it behoves us to develop first a clearer understanding of the lives and experiences of children and families who seek our help and to use this knowledge and understanding to plan and provide more grounded and responsive services.
Collapse
Affiliation(s)
- Philip Darbyshire
- Children, Youth & Women's Health Service, University of South Australia and Flinders University, Department of Nursing and Midwifery Research and Practice Development, Women's and Children's Hospital, Adelaide, Australia.
| | | | | |
Collapse
|
8
|
Batte S, Watson AR, Amess K. The effects of chronic renal failure on siblings. Pediatr Nephrol 2006; 21:246-50. [PMID: 16240159 DOI: 10.1007/s00467-005-2064-9] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2005] [Revised: 07/06/2005] [Accepted: 07/12/2005] [Indexed: 11/25/2022]
Abstract
It is well recognised that chronic illness in children can have a significant effect upon siblings, but their viewpoints need to be sought if we are to change our practice. We conducted semi-structured interviews at home with 15 siblings (8 males) aged 8-12 years whose brother/sister were on chronic dialysis or had received or were waiting for a renal transplant. The interviews were analysed using a grounded theory approach. The children also completed the Spence Children's Anxiety Scale (SCAS), which revealed no statistically significant evidence that they were exhibiting chronic clinical anxiety. Qualitative data indicated that siblings had a variety of concerns concerning their own health and that of their siblings and worried about the effects on family routine and separation from parents. The siblings felt more protective towards their chronically ill sibling and felt that they themselves needed to be more grown up. The study has implications for our clinical practice in that our psychosocial assessment of families needs to include an assessment of sibling needs and siblings should be involved when preparing patients for chronic renal failure treatment. The importance of maintaining family routines should be emphasised, as well as trying to involve siblings in unit activities.
Collapse
Affiliation(s)
- Suzanne Batte
- Children and Young People's Kidney Unit, City Hospital, Hucknall Road, Nottingham NG5 1PB, UK
| | | | | |
Collapse
|