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接受肾脏替代治疗的儿童和青少年的主要照料者的负担、抑郁和焦虑

Burden, depression and anxiety in primary caregivers of children and adolescents in renal replacement therapy.

作者信息

Lima Angélica Godoy Torres, Sales Clécia Cristiane da Silva, Serafim Welton Flávio de Lima

机构信息

Instituto Federal de Educação, Ciência e Tecnologia de Pernambuco, Belo Jardim, PE, Brasil.

Instituto de Medicina Integral Professor Fernando Figueira, Recife, PE, Brasil.

出版信息

J Bras Nefrol. 2019 Jul-Sep;41(3):356-363. doi: 10.1590/2175-8239-JBN-2018-0039. Epub 2019 Feb 21.

Abstract

INTRODUCTION

Chronic kidney disease (CKD) is rare in children, but it causes repercussions in several aspects of life, because the disease and treatment cause great changes in the daily lives of the child and his family, increasing the burden on caregivers.

OBJECTIVE

To evaluate the burden of primary caregivers of children and adolescents who undergo renal replacement therapy (RRT).

METHODS

Cross-sectional, observational study performed at the Pediatric Renal Unit of a school hospital in the Northeast. Forty-nine primary caregivers of pediatric patients with CKD in RRT followed up in our clinic participated in the study. We used validated instruments to assess burden, depression and anxiety. We ran some tests to analyze the findings of burden, depression and anxiety in the sample.

RESULTS

Most of the caregivers are the mothers of these children (89.8%), aged between 36 and 45 years (46.9%), have Elementary School education only (55.1%) and reported feeling pain in the body (69.4%), but they did not have chronic disease. The majority of the children have been in RRT from 1 to 3 years (40.8%), aged from 9 to 11 years (30.6%), are male (55.1%), and under hemodialysis (38.8%). The caregivers had a moderate level of burden (2.10), a high prevalence of moderate to severe depression (18.4%) and anxiety (47%), and a strong correlation between burden, depression and anxiety.

CONCLUSIONS

Caring for a child with CKD is an intense experience, with negative consequences, due to uncertainties about the future and the very care these children require. We need to do something to help these caregivers better manage care, as well as cope with their own feelings.

摘要

引言

慢性肾脏病(CKD)在儿童中较为罕见,但它会在生活的多个方面产生影响,因为该疾病及其治疗会给儿童及其家庭的日常生活带来巨大变化,增加了照顾者的负担。

目的

评估接受肾脏替代治疗(RRT)的儿童和青少年的主要照顾者的负担。

方法

在东北部一家学校医院的儿科肾脏科进行了一项横断面观察性研究。在我们诊所接受随访的49名接受RRT的CKD儿科患者的主要照顾者参与了该研究。我们使用经过验证的工具来评估负担、抑郁和焦虑。我们进行了一些测试以分析样本中负担、抑郁和焦虑的结果。

结果

大多数照顾者是这些孩子的母亲(89.8%),年龄在36至45岁之间(46.9%),仅接受过小学教育(55.1%),并报告身体疼痛(69.4%),但他们没有慢性病。大多数儿童接受RRT的时间为1至3年(40.8%),年龄在9至11岁之间(30.6%),为男性(55.1%),并且正在接受血液透析(38.8%)。照顾者的负担水平为中度(2.10),中度至重度抑郁(18.4%)和焦虑(47%)的患病率较高,并且负担、抑郁和焦虑之间存在很强的相关性。

结论

照顾患有CKD的儿童是一种强烈的经历,会产生负面后果,这是由于对未来的不确定性以及这些儿童所需的护理本身。我们需要采取措施帮助这些照顾者更好地管理护理,以及应对他们自己的感受。

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