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.
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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: 272–275
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 720–749
Brodehl J, Offner G, Hoyer PF, Pichelmayr R (1990) Outcome in children with endstage renal disease. Acta Paediatr Jpn Overseas Ed 32: 598–609
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]: 37–47
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 550–559
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: 45–52
Umeyama T, Masegawa A, Ogawa O, et al (1984) Rehabilitation of pediatric renal allograft recipients: the present status and the problems. Transplant Proc 16: 1677–1680
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: 35–40
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: 59–103
EDTA Registry (1986) Instruction sheet for patient questionnaire. EDTA Registry, London
Statistisches Bundesamt (1987) Statistisches Jahrbuch 1985. Kohlhammer, Stuttgart
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, Bonn
Jonen G, Roche H (eds) (1982) The educational system in the Federal Republic of Germany. Foreign Office of the Federal Republic of Germany, Bonn
Bundesanstalt für Arbeit (1991) Amtliche Nachrichten, Arbeitsstatistik 1990 — Jahreszahlen. Bundesanstalt für Arbeit, Nürnberg, p 82
Engel K, Schärer K (1979) Testing cooperation in parents with children destined for home dialysis. Dial Transplant 8: 359–362
Matthews DE, Van Leeuwen JJ, Christensen L (1981) Psychosocial problems of young children and their families in a dialysis transplant program. Dial Transplant 10: 73–80
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 318–330
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: 457–465
Grupe WE, Greifer I, Greenspan SI, Lewis AL, Wolff G (1986) Psychosocial development in children with chronic renal insufficiency. Am J Kidney Dis 7: 324–328
Reynolds JM, Garralda ME, Postlethwaite RJ, Goh D (1991) Changes in psychosocial adjustment after renal transplantation. Arch Dis Child 66: 508–513
Brownbridge G, Fielding DM (1991) Psychosocial adjustment to end-stage renal failure: comparing haemodialysis, continuous ambulatory peritoneal dialysis and transplantation. Pediatr Nephrol 5: 612–616
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: 948–953
Mäkipernaa A (1989) Long-term quality of life and psychosocial coping after treatment of solid tumours in childhood. Acta Paediatr Scand 78: 728–735
Petermann F, Bode U, Schlack G (eds) (1990) Chronisch kranke Kinder und Jugendliche. Eine interdisziplinäre Aufgabe. Deutscher Ärzte Verlag, Köln
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 33–41
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]: 31–40
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. 14:550–554
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]: 33–41
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.
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: 214–218
Reichwald-Klugger E (1985) Die psychische Problematik des jugendlichen Dialysepatienten. In: Müller-Wiefel DE (ed) Der jugendliche Dialysepatient. Ahrend, Baunatal, pp 51–59
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Rosenkranz, J., Bonzel, KE., Bulla, M. et al. Psychosocial adaptation of children and adolescents with chronic renal failure. Pediatr Nephrol 6, 459–463 (1992). https://doi.org/10.1007/BF00874014
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DOI: https://doi.org/10.1007/BF00874014