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Psychosocial issues in children on hospital haemodialysis: nurses' views
J M Reynolds1, E M Garralda, R J Postlethwaite
1Department of Psychiatry, University of Manchester, Booth Hall Children's Hospital, Blackley, UK.
Insights
Nurses identified significant psychological adjustment and treatment compliance issues in approximately half of pediatric patients undergoing hospital hemodialysis. These findings underscore the need to recognize psychological factors in the nursing care of these children.
Area of Science:
- Pediatric Nephrology
- Child Psychology
- Nursing Care
Background:
- Chronic renal failure significantly impacts children's lives.
- Hospital hemodialysis presents unique challenges for pediatric patients.
- Psychological adjustment and treatment compliance are critical aspects of care.
Purpose of the Study:
- To assess psychological adjustment and treatment compliance in children and adolescents on hospital hemodialysis.
- To explore discrepancies in ratings of patient well-being and compliance.
- To emphasize the importance of psychological support in nursing care.
Main Methods:
- A sample of 21 children and adolescents undergoing hospital hemodialysis was studied.
- Nurses provided assessments of psychological adjustment and treatment compliance.
- Research psychiatric assessments and parent/child ratings were also considered.
Main Results:
- Nurses identified marked psychological adjustment problems in about half of the children.
- Nearly half showed poor compliance with non-dialysis treatment aspects.
- Discrepancies were noted between nurse, parent, and child ratings.
Conclusions:
- Psychological well-being and treatment compliance are significant concerns for pediatric hemodialysis patients.
- Nursing assessments highlight substantial psychological challenges.
- Recognizing and addressing psychological aspects is crucial in the nursing care of children with chronic renal failure.
Abstract:
In a sample of 21 children and adolescents on hospital haemodialysis, nurses identified a substantial percentage of the children (about half) as having marked problems in psychological adjustment. Nearly half of the children were also regarded as showing poor compliance with aspects of treatment other than dialysis. More children were rated as disturbed by nursing than by research psychiatric assessments; there was limited congruence between nurses' and parent/child ratings of problems in physical well-being or in treatment compliance. The reasons for these discrepancies are explored. Our results highlight the importance that psychological aspects in the nursing of children with chronic renal failure on hospital haemodialysis are recognised.