Abstract
BackgroundThe caregivers of children on peritoneal dialysis face heavy care burdens and may have a high risk of depression. This study aimed to describe the prevalence and severity of depression and identify its related demographic and socioeconomic factors in the caregivers of children on peritoneal dialysis in China.MethodsA multicenter cross-sectional study was conducted in four pediatric dialysis centers in four tertiary children’s hospitals in mainland China. Primary caregivers of children with end-stage kidney disease and currently on peritoneal dialysis were screened and recruited from December 2018 to July 2019. A self-developed questionnaire and the Self-Rating Depression Scale (SDS) were administered to the participants by a trained nurse in each center. The chi-square test or Fisher’s exact test, one-way ANOVA, and the Mann-Whitney U test were used to compare the prevalence of depressive symptoms by demographic features. A multivariate logistic regression analysis was used to identify factors related to depressive symptoms in caregivers of children on peritoneal dialysis.ResultsOne hundred twenty-one caregivers were included in the data analysis. The mean age of the caregivers was 40.1 ± 8.1 years. More than 75% of the participants were female, married, and unemployed. The overall prevalence of depressive symptoms was 59%. In total, 46 (38%), 20 (17%) and 5 (4%) caregivers reported mild, moderate, and severe depressive symptoms, respectively. In the univariate analysis, caregivers with an average household income per month under 4000 RMB and caregivers of children undergoing laparoscopic surgery had a higher prevalence of depressive symptoms. Characteristics such as treatment center, duration on PD, PD modalities, and history of peritonitis episodes showed no difference in terms of the prevalence of depressive symptoms. The multivariate logistic regression analysis demonstrated that an average household income per month under 4000 RMB was the associated factor for caregivers’ depressive symptoms.ConclusionsThe caregivers of children on peritoneal dialysis in mainland China were socially vulnerable and experienced depression. Those who had a higher average household income were less vulnerable to depression.
Highlights
The caregivers of children on peritoneal dialysis face heavy care burdens and may have a high risk of depression
Aim This study aimed to understand the features of demographics of caregivers with a child on peritoneal dialysis (PD), to describe the prevalence and severity of depression, and to identify its related demographic and socioeconomic factors in the caregivers of children on PD in mainland China
There were no significant differences between the depression group and the nondepression group concerning child’s age (10.0 ± 4.1 years vs 9.6 ± 4.6 years, F = 0.1, P = 0.7), caregiver’s age (38.3 ± 8.6 years vs 41.1 ± 8.4 years, F = 2.2, P = 0.1), and duration on PD (9 months vs 10 months, Z = -0.5, P = 0.6)
Summary
The caregivers of children on peritoneal dialysis face heavy care burdens and may have a high risk of depression. This study aimed to describe the prevalence and severity of depression and identify its related demographic and socioeconomic factors in the caregivers of children on peritoneal dialysis in China. Kidney replacement therapy (KRT), including peritoneal dialysis (PD), hemodialysis, and kidney transplantation, is a life-saving treatment for children with end-stage kidney disease (ESKD). PD is recommended as the initial dialysis treatment of choice for ESKD in children aged 2 years or older and as the best option for infants [1, 2]. The median incidence of KRT in children aged less than 20 years is approximately 9 per million age-related population [3]. According to the International Pediatric Peritoneal Dialysis Network-China (IPDN-China) [5], by the end of August 2019, there were 470 PD children registered for and 258 currently on PD from 40 PD centers in China [6]
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