Psychosocial support for children and families requiring renal replacement therapy

Abstract

Chronic kidney disease (CKD) and the need for renal replacement therapy (RRT) can place a great strain on the child and family. As well as the medical and nutritional prescription, each child and family requires an individual psychosocial prescription that requires input from multiprofessional team members. The information needs of each child and family need to be constantly evaluated as well as the choice of therapy in relation to social, psychological and economic factors. Many tertiary units lack adequate "time" to deliver such assessments and coordinate the support and respite care for those on long-term dialysis, especially when significant numbers of children are now accepted onto RRT programmes with co-morbidities. National and international standards are needed for the staffing of comprehensive tertiary paediatric renal units as well as studies evaluating supportive care to families.

Do Clinical And Psychosocial Factors Affect Health-Related Quality of Life in Adolescents with Chronic Diseases?

“…Thus, these results support the suggestions in the literature emphasizing more the importance to focus on the disease's impact on psychosocial dimensions, and less on the diagnostic categories/physical dimensions (Denny et al, 2014;Mackner et al, 2012;van der Lee et al, 2007). In addition, the results underline previous research recommendations, namely the need to include psychosocial factors in complement of health indicators (Health, 2013;Watson, 2014), and the relevance of routinely conduct its assessment in clinical and pediatric settings (Mellion et al, 2014;Moreira et al, 2013;Williams et al, 2013). However, it may be suggested somehow a relationship between SR, the educational level of parents and the clinical variables (that need to be studied with more detail), considering that this psychosocial variable was no longer significant in the step 1 of Model 1 and in step 2 of both Model 1 and Model 2.…”

“…In addition, it also underlines previous research recommendations, proposing that in the specific period of adolescence Carona, Silva, & Moreira, 2015), it is crucial to include psychosocial dimensions in complement of traditional health indicators (Health, 2013;Watson, 2014, Pulkki-Råback et al, 2015Varni et al, 2007) and to routinely conduct its assessment in clinical and pediatric settings (Mellion et al, 2014;Moreira et al, 2013). Furthermore, to identify the impaired psychosocial domains, can give potentially useful suggestions, that better help to plan and guide interventions aiming to improve an integral perspective that represents the holistic care for these adolescents (Alba et al, 2013;Elsenbruch et al, 2013;Mazur & Małkowska-Szkutnik, 2010;Marmot et al, 2012).…”

“…Supporting this idea, clinical settings have been progressively recognizing the need to complement traditional health indicators with psychosocial factors (Health, 2013;Watson, 2014), which requires a routinely assessment in pediatric contexts (Mellion et al, 2014;Moreira et al, 2013). Moreover, to include such factors in clinical decision making and research is necessary, mainly once to manage symptons and to improve psychosocial care are nowadays primary goals of interventions (Elsenbruch et al, 2013;Health, 2003;Marmot et al, 2012;Pulkki-Råback et al, 2015;Watson, 2014).…”

Adolescent’s subjective perceptions of chronic disease and related psychosocial factors: highlights from an outpatient context study

“…In addition, as a child advances in age, physical and biomedical factors diminish their importance as determinants of self-perceived QoL, and psychosocial factors become relevant [26]. Thus, psychosocial variables assume an important role, more than the presence per se of physical dimensions of the health condition [1, 12, 27], and to address psychosocial dimensions is crucial for the holistic care of these children and adolescents [28–32]. Literature concerning the assessment of such dimensions, including research comparing children’s and parents’ QoL (Quality of Life) across several health conditions, and children with different health conditions [33, 34] has been identified.…”

Peritoneal Dialysis in Children

“…The preference for APD has mostly been a lifestyle choice, since the nighttime APD course enables children to attend school full time and reduces the impact of dialysis treatment on the way of life of the patients and their families [59,310]. The wide range of APD schedules help in tailoring dialysis prescription to patient's age, body size, clinical conditions, growth-related metabolic needs, residual renal function, and PM transport status.…”