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[Psychosocial problems of children with chronic disease]
Insights
Children with end-stage renal disease (ESRD) experience psychosocial issues like depression and anxiety, impacting rehabilitation. A pluridimensional approach improved coping for patients, families, and healthcare teams.
Area of Science:
- Psychology
- Pediatrics
- Nephrology
Context:
- Children with chronic diseases, specifically end-stage renal disease (ESRD), face significant psychosocial challenges.
- Family dynamics and professional team interactions are also affected by pediatric ESRD.
Purpose:
- To study psychosocial problems in children with chronic disease.
- To apply and evaluate a pluridimensional approach model for resolving conflicts in pediatric ESRD patients, families, and healthcare teams.
Summary:
- Psychosocial issues such as depression, anxiety, and regression were observed in children with ESRD, hindering rehabilitation.
- Poverty exacerbated these problems, while families experienced fragmentation and conflict. Healthcare teams showed tension and communication difficulties.
- The pluridimensional approach integrated psychological interventions, occupational therapy, and group sessions to modify pathological interaction patterns.
Impact:
- The study highlights the complex psychosocial burden of pediatric ESRD.
- The pluridimensional approach demonstrated potential in mitigating negative impacts and fostering therapeutic interactions within the pediatric ESRD context.
Abstract:
This presentation comprises: a) the study of psychosocial problems in children with chronic disease (1980-83); b) application and results of a "pluridimensional approach" model, designed to solve these conflicts (1982-88). Thirty-five children with end stage renal disease (ESRD) and 34 families were studied, as well as the members of the professional team. The methods of study were: conducted observations, projective tests, recording and analysis of psychotherapy (individual and familiar) and Balint sessions. The data were analized in the framework of psychoanalysis, theory of the systems and groups, etc. The results showed: depression, anguish and regression, interfering with rehabilitation, in the group of children. The problems worsening with greater length of the dialysis periods and with younger age of the patients. Poverty increases losses and guilty feelings decreasing the defensive and adaptive mechanisms. In the families, ESRD provoked migration, fragmentation, dynamic and structural dysfunctions and several inter and intrapersonal conflicts. In the professional team, tension, anxiety, compulsive and indiscriminate conducts were detected, as well as a great difficulty to communicate with the patients and their families. In an attempt to decrease these conflicts a pluridimensional approach was designed and applied in the patients, families and members of the professional team, with the aim of interrupt the pathologic interaction patterns and change them in therapeutic. This model included the practice of several independent and simultaneous psychological interventions, ergotherapy, recreative and occupational activities with the patients; group sessions for information, diagnostic interviews and psychotherapy with the families and Balint sessions with the professional team.(ABSTRACT TRUNCATED AT 250 WORDS)