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Pediatric Nephrology

, Volume 6, Issue 5, pp 459–463 | Cite as

Psychosocial adaptation of children and adolescents with chronic renal failure

  • Joachim Rosenkranz
  • Klaus-Eugen Bonzel
  • Monika Bulla
  • Dietrich Michalk
  • Gisela Offner
  • Evelyn Reichwald-Klugger
  • Karl Schärer
Original Article

Abstract

In a multicentre study comprising five paediatric nephrology centres in Western Germany, psychosocial and educational parameters were assessed (during 1987) in 479 children and adolescents with chronic renal failure (CRF) in order to gain insight into their psychosocial adaptation to the disease. At the time of assessment, 31% of patients were on conservative treatment, 14% on haemodialysis, 9% on continuous ambulatory peritoneal dialysis and 46% had a functioning transplant. The mean age at assessment was 13.6 years. Additional disabilities were noted in 29% of patients. School attendance of the 233 children of school age was in general satisfactory; 22% of patients attended schools for disabled or handicapped children. Vocational training was frequently inadequate, especially for dialysed patients, and only 14 of 53 adolescents over 16 years had graduated. Of 49 adult patients, only 21 were in some form of employment. A lack of age-appropriate independence was observed in a large proportion (86%) of patients over 17 years, who continued to live with their parents or other persons taking care of them, whilst only 14% were living alone or with a partner. We conclude that, despite improved survival, psychosocial adaptation continues to be impaired in paediatric patients with CRF, especially in adolescents and those on dialysis.

Key words

Chronic renal failure Psychosocial care Dialysis Transplantation Rehabilitation 

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References

  1. 1.
    Pistor K, Schärer K, Olbing H, Tamminen-Möbius T (1985) Children with chronic renal failure in the Federal Republic of Germany. I. Epidemiology, modes of treatment, survival. Clin Nephrol 23: 272–275Google Scholar
  2. 2.
    Broyer M, Chantler C, Donckerwolcke R, Rizzoni G (1989) Renal replacement therapy in children. In: Maher JF (ed) Replacement of renal function by dialysis. Kluwer, Dordrecht, pp 720–749Google Scholar
  3. 3.
    Brodehl J, Offner G, Hoyer PF, Pichelmayr R (1990) Outcome in children with endstage renal disease. Acta Paediatr Jpn Overseas Ed 32: 598–609Google Scholar
  4. 4.
    Ehrich JHH, Rizzoni G, Brunner FP, Brynger H, Geerlings W, Fassbinder W, Raine AEG, Selwood NH, Tufveson G (1991) Combined report on regular dialysis and transplantation of children in Europe, 1989. Nephrol Dial Transplant 6 [Suppl 1]: 37–47Google Scholar
  5. 5.
    Korsch BM, Francis-Negrete V (1984) Psychosocial adaptation of children with ESRD: factors affecting rehabilitation. In: Fine RN, Gruskin AB (eds) End stage renal disease in children. Saunders, Philadelphia, pp 550–559Google Scholar
  6. 6.
    Reichwald-Klugger E, Tieben-Heibert A, Korn R, Stein L, Weck K, Maiwald G, Mehls O, Diekmann L, Müller-Wiefel DE, Jochmus I, Schärer K (1984) Psychosocial adaptation of children and their parents to hospital and home hemodialysis. Int J Pediatr Nephrol 5: 45–52Google Scholar
  7. 7.
    Umeyama T, Masegawa A, Ogawa O, et al (1984) Rehabilitation of pediatric renal allograft recipients: the present status and the problems. Transplant Proc 16: 1677–1680Google Scholar
  8. 8.
    Henning P, Tomlinson L, Ridgen SPA, Haycock GB, Chantler C (1988) Long-term outcome of treatment of end-stage renal failure. Arch Dis Child 63: 35–40Google Scholar
  9. 9.
    Schärer K, Chantler C, Brunner FP, Gurland H, Jacobs C, Selwood NH, Spies G, Wing AJ (1976) Combined report on regular dialysis and transplantation in Europe, 1975. Proc Eur Dial Transplant Assoc 13: 59–103Google Scholar
  10. 10.
    EDTA Registry (1986) Instruction sheet for patient questionnaire. EDTA Registry, LondonGoogle Scholar
  11. 11.
    Statistisches Bundesamt (1987) Statistisches Jahrbuch 1985. Kohlhammer, StuttgartGoogle Scholar
  12. 12.
    Statistische Veröffentlichungen der Kultusministerkonferenz (1991) Schüler, Klassen, Lehrer und Absolventen der Schulen 1980 bis 1989. Sekretariat der ständigen Konferenz der Kultusminister in der Bundesrepublik Deutschland, BonnGoogle Scholar
  13. 13.
    Jonen G, Roche H (eds) (1982) The educational system in the Federal Republic of Germany. Foreign Office of the Federal Republic of Germany, BonnGoogle Scholar
  14. 14.
    Bundesanstalt für Arbeit (1991) Amtliche Nachrichten, Arbeitsstatistik 1990 — Jahreszahlen. Bundesanstalt für Arbeit, Nürnberg, p 82Google Scholar
  15. 15.
    Engel K, Schärer K (1979) Testing cooperation in parents with children destined for home dialysis. Dial Transplant 8: 359–362Google Scholar
  16. 16.
    Matthews DE, Van Leeuwen JJ, Christensen L (1981) Psychosocial problems of young children and their families in a dialysis transplant program. Dial Transplant 10: 73–80Google Scholar
  17. 17.
    Wolff G, Brix J, Ostermann E (1985) Psychosoziale Probleme bei der Hämodialyse und Transplantation von Kindern und Jugendlichen. In: Balck F, Koch V, Speidel H (eds) Psychonephrologie. Springer, Berlin Heidelberg New York, pp 318–330Google Scholar
  18. 18.
    Fielding D, Moore B, Dewey M, Ashley P, McKendrick T, Pinkerton P (1985) Children with end-stage renal failure: psychological effects on patients, siblings and parents. J Psychosom Res 29: 457–465Google Scholar
  19. 19.
    Grupe WE, Greifer I, Greenspan SI, Lewis AL, Wolff G (1986) Psychosocial development in children with chronic renal insufficiency. Am J Kidney Dis 7: 324–328Google Scholar
  20. 20.
    Reynolds JM, Garralda ME, Postlethwaite RJ, Goh D (1991) Changes in psychosocial adjustment after renal transplantation. Arch Dis Child 66: 508–513Google Scholar
  21. 21.
    Brownbridge G, Fielding DM (1991) Psychosocial adjustment to end-stage renal failure: comparing haemodialysis, continuous ambulatory peritoneal dialysis and transplantation. Pediatr Nephrol 5: 612–616Google Scholar
  22. 22.
    Roscoe JM, Smith LF, Williams EA, Stein M, Morton AR, Balfe JW, Arbus GS (1991) Medical and social outcome in adolescents with end-stage renal failure. Kidney Int 40: 948–953Google Scholar
  23. 23.
    Mäkipernaa A (1989) Long-term quality of life and psychosocial coping after treatment of solid tumours in childhood. Acta Paediatr Scand 78: 728–735Google Scholar
  24. 24.
    Petermann F, Bode U, Schlack G (eds) (1990) Chronisch kranke Kinder und Jugendliche. Eine interdisziplinäre Aufgabe. Deutscher Ärzte Verlag, KölnGoogle Scholar
  25. 25.
    Ehrich JHH, Rizzoni G, Broyer M, Brunner FP, Dykes SR, Geerlings W, Fassbinder W, Tufveson G, Selwood NH, Wing AJ (1988) Combined report on regular dialysis and transplantation of children in Europe, 1987, Springer, London, p 33–41Google Scholar
  26. 26.
    Rizzoni G, Ehrich JHH, Brunner FP, Brynger H, Dykes SR, Geerlings W, Fassbinder W, Tufveson G, Selwood NH, Wing AJ (1989) Combined report on regular dialysis and transplantation of children in Europe, 1988. Nephrol Dial Transplant 4 [Suppl 4]: 31–40Google Scholar
  27. 27.
    Huber W, Pytlik K (1985) Erfahrungen im Bereich der beruflichen Rehabilitation bei chronischer Niereninsuffizienz bei jugendlichen Patienten im Alter von 17–23 Jahren. Nieren- und Hochdruckkrankh. 14:550–554Google Scholar
  28. 28.
    Ehrich JHH, Rizzoni G, Broyer M, Brunner FP, Brynger H, Dykes SR, Geerlings W, Fassbinder W, Tufveson G, Selwood NH, Wing AJ (1989) Combined report on regular dialysis and transplantation of children in Europe, 1987. Nephrol Dial Transplant 4 [Suppl 2]: 33–41Google Scholar
  29. 29.
    Chantler C, Broyer M, Donckerwolcke RA, Brynger H, Brunner FP, Jacobs C, Kramer P, Selwood NH, Wing AJ (1981) Growth and rehabilitation of long-term survivors of treatment for end-stage renal failure in childhood. Proc Eur Dial Transplant Assoc 18: 329–339.Google Scholar
  30. 30.
    Sayag R, Kaplan De-Nour A, Shapira Z, Kahan E, Boner G (1990) Comparison of psychosocial adjustment of male nondiabetic kidney transplant and hospital hemodialysis patients. Nephron 54: 214–218Google Scholar
  31. 31.
    Reichwald-Klugger E (1985) Die psychische Problematik des jugendlichen Dialysepatienten. In: Müller-Wiefel DE (ed) Der jugendliche Dialysepatient. Ahrend, Baunatal, pp 51–59Google Scholar

Copyright information

© IPNA 1992

Authors and Affiliations

  • Joachim Rosenkranz
    • 1
  • Klaus-Eugen Bonzel
    • 2
  • Monika Bulla
    • 3
  • Dietrich Michalk
    • 4
  • Gisela Offner
    • 5
  • Evelyn Reichwald-Klugger
    • 1
  • Karl Schärer
    • 1
  1. 1.Department of Paediatric Nephrology of University Children's Hospital of HeidelbergHeidelbergFederal Republic of Germany
  2. 2.Department of Paediatric Nephrology of University Children's Hospital of EssenFederal Republic of Germany
  3. 3.Department of Paediatric Nephrology of University Children's Hospital of MünsterFederal Republic of Germany
  4. 4.Department of Paediatric Nephrology of University Children's Hospital of CologneFederal Republic of Germany
  5. 5.Department of Paediatric Nephrology of University Children's Hospital of HannoverFederal Republic of Germany

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