Social Support and Loneliness Among Chinese Caregivers of Children With Chronic Kidney Disease During the COVID-19 Pandemic: A Propensity Score Matching Analysis

Psychological research of the children with chronic kidney disease and their guardians during the COVID-19 pandemic

Background

There is great mental stress due to the coronavirus disease 2019 (COVID-19) pandemic. However, there are no detailed psychological studies of the children with chronic kidney disease (CKD) and their guardians during the COVID-19 pandemic.

Objective

This study explores the psychological pressure on children with CKD and their guardians.

Methods

An online survey was conducted at 20 of the largest pediatric nephropathy departments in China, including the Rutter Parent Questionnaire, Self-rating Anxiety Scale (SAS), and Self-rating Depression Scale (SDS). Overall, 885 children (589 children with CKD associated with 296 children of the control group) completed the survey together with their guardians.

Results

There was no statistical difference between CKD children and control children regarding their Rutter behavior scores and abnormal behaviors. Nevertheless, the abnormal behavior of children might aggravate the anxiety and depression of guardians in both CKD and control groups (p < 0.05). We confirmed that the anxiety and depression of guardians in the CKD group were both significantly higher than those in the control group (p < 0.05). The guardians in the CKD group with lower annual income were more likely to experience anxiety (p < 0.05). Furthermore, the guardians whose children were older than 11 years old might be more anxious than those who were 6-11 years old. Besides, the guardians in the CKD group who watched the news for 30-60 min daily were less likely to have depression than those who watched < 10 min (p < 0.05). The subgroup results showed that the gender, the time of watching the news, the annual income of guardians, and children's age might be the most critical factors influencing guardians' psychological burden.

Conclusion

The guardians in the CKD group have more severe anxiety and depression during the pandemic. The children's abnormal behavior, adolescents' pressure, low household income, and the panic about the pandemic may be the main reasons for the anxiety and depression of guardians.

Interventions and strategies to improve social support for caregivers of children with chronic diseases: An umbrella review

BACKGROUND

Social support is an important approach to improve the psychosocial health status and promote positive coping for caregivers of children with chronic diseases. Such an approach can reduce parenting stress, help resolve parenting difficulties through the use of various social support relationships.

METHODS

We performed an umbrella review methodology using the method of examination, analysis and synthesis of systematic reviews. A PRISMA flow diagram was used to show the search process. The Joanna Briggs Institute was used to appraise the quality of papers and a narrative synthesis was undertaken. Relevant English and Chinese systematic reviews were searched in Embase, PubMed, Web of science, OVID, CNKI, CBM, Wan Fang and Cochrane Library databases, until November 2021, June 2022.

RESULTS

Out of 1,905 records, we included fourteen systematic reviews for a synthesis. Evidence to promote social support for caregivers of children with chronic diseases was identified from four key aspects: (i) Intervention content; (ii) Intervention forms; (iii) Intervention time; and (iv) Sources of support.

CONCLUSIONS

The findings of this review suggest that a combination of differing interventions, especially for early family, including the content of parenting training or education, attitude building and resource provision, which can implement online is recommend. More interventional studies and quantitative evidence syntheses are still needed.

IMPACT

Adequate social support is essential to promote the psychological wellbeing of caregivers of children with chronic diseases. In the early stage of children's diseases, integrating different content and forms of interventions for caregivers' families and actively helping caregivers to identify available support resources can improve social support. The findings from this review can be used to guide caregivers of children with chronic diseases and provide evidence for healthcare professionals and social workers to carry out relevant interventions.

Loneliness Level and Its Associated Factors in Patients With Hemodialysis

Verify the level of loneliness and its relationship with socioeconomic and health conditions, social support, family functionality, and depressive symptoms in patients undergoing hemodialysis. Analysis of secondary data, with a primary cross-sectional investigation, correlational with a quantitative approach, carried out in 2019, with 80 patients with CKD on hemodialysis. Applied instruments: socio-demographic, economic, and health condition characterization, UCLA Loneliness Scale, Medical Outcomes Study Social Support Scale, Patient Health Questionnaire9, and the Family APGAR. Showed female prevalence (55%), white ethnicity (65%), and mean age 59.63 years. In the perception of loneliness, the highest index was (55%), moderately high. Social support scored worst in the Positive Social Interaction domain, mean 74.31. In depression, showed prevalence of severe depression (28.7%). Family functioning showed good score (68.8%). There was a weak negative correlation between loneliness and all domains of Social Support, besides Family Functioning.

Neglected Needs of Family Caregivers during the COVID-19 Pandemic and What They Need Now: A Qualitative Study

COVID-19 has had a negative impact on family caregivers, whether the care receivers lived with the caregiver, in a separate community home, in supportive living, or in long-term care. This qualitative study examines the points of view of family caregivers who care in diverse settings. Family caregivers were asked to describe what could have been done to support them during the COVID-19 pandemic and to suggest supports they need in the future as the pandemic wanes. Thorne's interpretive qualitative methodology was employed to examine current caregiver concerns. Thirty-two family caregivers participated. Family caregivers thought the under-resourced, continuing care system delayed pandemic planning, and that silos in health and community systems made caregiving more difficult. Family caregivers want their roles to be recognized in policy, and they cite the need for improvements in communication and navigation. The growth in demand for family caregivers and their contributions to the healthcare system make it critical that the family caregiver role be recognized in policy, funding, and practice.