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Family environment, child behavior, and medical indicators in children with kidney disease
1Psychology Program, WSU Vancouver, 14204 NE Salmon Creek Ave., Vancouver, WA 98686, USA. soliday@vancouver.wsu.edu
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Family environment impacts child behavior and medical needs in children with kidney disease. Higher family conflict correlated with more externalizing symptoms and medications, while cohesion reduced hospitalizations.
Area of Science:
- Pediatric Nephrology
- Child Psychology
- Family Studies
Background:
- Childhood kidney diseases, including nephrotic syndrome, chronic renal insufficiency, and kidney transplant, present unique challenges.
- The family environment is a critical factor influencing child health outcomes and behavior.
- Understanding the interplay between family dynamics and pediatric health is essential for effective care.
Purpose of the Study:
- To examine the effects of the family environment on behavior symptoms and medical indicators in children with specific kidney diseases.
- To identify specific family environment factors associated with child behavior and medical utilization.
- To explore the relationship between family structure and medical treatment needs.
Main Methods:
- Survey methodology involving parents of 41 children diagnosed with nephrotic syndrome, chronic renal insufficiency, or kidney transplant.
- Utilized validated questionnaires to assess family environment and child behavior symptoms.
- Collected medical indicators, including healthcare utilization and medication data, from medical records.
Main Results:
- A predictive model incorporating child age, diagnostic group, and family environment variables explained most outcomes, excluding internalizing behaviors.
- Increased family conflict was linked to higher rates of externalizing behaviors and a greater number of prescribed medications.
- Enhanced family cohesion was associated with fewer hospitalizations.
- Non-traditional family structures correlated with an increased number of prescribed medications.
Conclusions:
- Family environment variables significantly influence child behavior symptoms and medical indicators in pediatric kidney disease.
- Family conflict and cohesion appear to be key factors affecting symptom expression and healthcare utilization.
- Clinical interventions should consider family dynamics to improve outcomes for children with kidney diseases.
Abstract:
Effects of family environment on child behavior symptoms and medical indicators in children with one of three kidney diseases were examined. Parents (n = 41) of children with nephrotic syndrome, chronic renal insufficiency, or kidney transplant completed family environment and child behavior questionnaires. Medical indicators (utilization and medications) were collected from medical records. A model including child age, diagnostic group, and family environment variables successfully predicted all outcomes except internalizing behavior. Higher family conflict predicted more externalizing symptoms and higher number of prescribed medications; higher family cohesion predicted fewer hospitalizations. Nontraditional family structure predicted higher number of prescribed medications. Results are discussed as they relate to a stress and resistance framework, need for research on direction of effect, and clinical recommendations.