Psychological adjustment in children with end stage renal disease: the impact of maternal stress and coping.

Abstract

To explore maternal and child perspectives on children's adjustment in the context of paediatric renal disease, and maternal psychological variables that may account for variance in child and maternal ratings. Forty-three children with end stage renal disease and their maternal caregivers completed the Strengths and Difficulties Questionnaire (SDQ). Mothers also reported on their own mental health, and the strategies they used to cope with their child's illness. The severity of the child's condition was rated independently by a renal clinician. Compared with normative data for the SDQ mothers reported their children to be at increased risk of psychological problems. However, the children themselves reported no more problems than a normative sample. Mothers' coping and mental health explained some of the variance in their ratings of the child's adjustment but were not predictive of the children's self-ratings. The results suggest that maternal factors may not explain the variability in children's adjustment to chronic illness, perhaps especially within the age range studied here. Practical implications of the data are also discussed. In particular, a systemic approach to paediatric liaison by psychologists is emphasized.