Great North Children's Hospital, Newcastle Upon Tyne, UK.
School of Health Sciences, University of Southampton, Southampton, UK.
Pediatr Nephrol. 2021 Sep;36(9):2797-2810. doi: 10.1007/s00467-021-05041-8. Epub 2021 Mar 19.
During the initial COVID-19 pandemic, young United Kingdom (UK) kidney patients underwent lockdown and those with increased vulnerabilities socially isolated or 'shielded' at home. The experiences, information needs, decision-making and support needs of children and young adult (CYA) patients or their parents during this period is not well known.
A UK-wide online survey co-produced with patients was conducted in May 2020 amongst CYA aged 12-30, or parents of children aged < 18 years with any long-term kidney condition. Participants answered qualitative open text alongside quantitative closed questions. Thematic content analysis using a three-stage coding process was conducted.
One-hundred and eighteen CYA (median age 21) and 197 parents of children (median age 10) responded. Predominant concerns from CYA were heightened vigilance about viral (68%) and kidney symptoms (77%) and detrimental impact on education or work opportunities (70%). Parents feared the virus more than CYA (71% vs. 40%), and had concerns that their child would catch the virus from them (64%) and would have an adverse impact on other children at home (65%). CYA thematic analysis revealed strong belief of becoming seriously ill if they contracted COVID-19; lost educational opportunities, socialisation and career development; and frustration with the public for not following social distancing rules. Positive outcomes included improved family relationships and community cohesion. Only a minority (14-21% CYA and 20-31% parents, merged questions) desired more support. Subgroup analysis identified greater negative psychological impact in the shielded group.
This survey demonstrates substantial concern and need for accurate tailored advice for CYA based on individualised risks to improve shared decision making.
在 COVID-19 大流行初期,英国(UK)的年轻肾病患者经历了封锁,那些社会弱势或有更高脆弱性的患者在家中被隔离或“保护”。在此期间,儿童和青少年(CYA)患者或其父母的经历、信息需求、决策和支持需求并不为人所知。
2020 年 5 月,在与患者共同制作的基础上,在英国范围内进行了一项在线调查,调查对象为 12-30 岁的 CYA,或患有任何长期肾脏疾病、年龄<18 岁的儿童的父母。参与者回答了定性的开放性文本以及定量的封闭性问题。采用三阶段编码过程进行主题内容分析。
118 名 CYA(中位数年龄 21 岁)和 197 名儿童的父母(中位数年龄 10 岁)做出了回应。CYA 最关心的问题是对病毒(68%)和肾脏症状(77%)的高度警惕,以及对教育或工作机会的不利影响(70%)。父母比 CYA 更担心病毒(71%对 40%),并且担心他们的孩子会从他们那里感染病毒(64%),并且会对家中的其他孩子产生不利影响(65%)。CYA 的主题分析显示,他们坚信如果感染 COVID-19,他们会病重;失去了教育机会、社交和职业发展;并对公众不遵守社交距离规则感到沮丧。积极的结果包括改善家庭关系和社区凝聚力。只有少数人(14-21%的 CYA 和 20-31%的父母,合并问题)希望得到更多的支持。亚组分析发现,被隔离组的负面心理影响更大。
这项调查表明,需要根据个人风险为 CYA 提供准确的、量身定制的建议,以改善共同决策,从而满足他们的高度关注和需求。