Duquette Peter J, Donewar Crista W, Hooper Stephen R
School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
Duke University School of Medicine, Durham, NC, USA.
Pediatr Nephrol. 2025 Sep 2. doi: 10.1007/s00467-025-06936-6.
Parental stress in pediatric chronic illness is well known; however, there is a dearth of literature describing parental stress in pediatric chronic kidney disease (CKD). This pilot study evaluated parenting stress in mild to moderate pediatric CKD relative to caregivers of healthy, typically developing children.
The study included 38 children, ages 6 to 12 years, and their parents (CKD Group = 10, Typical Group = 28). Pediatric CKD participants had mild to moderate kidney dysfunction for at least 3 months. Parents completed the Parenting Stress Index (PSI-3) as a measure of their current stress.
Serial linear regressions revealed no significant group differences on the Child, Parent, Total Stress, or Life Stress domains; however, exploratory analyses revealed significant parental stress on the subscales of Mood and Acceptability, as well as concerns about their own Competence and Health. Compared to the control group, parents of patients with CKD also reported significantly high levels of stress on Adaptability (50% versus 21.4%), Mood (60% versus 25%), and Acceptability (50% versus 10.7%).
While overall levels of parenting stress were not unduly elevated in group comparisons, increased stress levels with respect to their child's mood, acceptability, and their own personal health were noted. The proportion of CKD parent ratings reaching significantly high stress levels also was uniformly high, particularly in Adaptability, Mood, Acceptability, (parental) Competence, and Total Stress. These pilot results should guide future studies exploring parent/family factors and potential interventions for reducing parenting stress and related burdens in the clinical care of children with CKD.
小儿慢性病中父母压力是众所周知的；然而，描述小儿慢性肾病（CKD）中父母压力的文献却很匮乏。这项试点研究评估了轻度至中度小儿CKD中父母的压力，并与健康、发育正常儿童的照料者进行了比较。
该研究纳入了38名6至12岁的儿童及其父母（CKD组 = 10名，正常组 = 28名）。小儿CKD参与者有轻度至中度肾功能不全至少3个月。父母完成育儿压力指数（PSI-3）作为其当前压力的衡量指标。
系列线性回归显示，在儿童、父母、总压力或生活压力领域，两组之间无显著差异；然而，探索性分析显示，在情绪和可接受性分量表上父母压力显著，以及对自身能力和健康的担忧。与对照组相比，CKD患者的父母在适应性（50%对21.4%）、情绪（60%对25%）和可接受性（50%对10.7%）方面也报告了显著更高的压力水平。
虽然在组间比较中育儿压力的总体水平没有过度升高，但注意到在孩子的情绪、可接受性以及自身健康方面压力水平有所增加。达到显著高压力水平的CKD父母评分比例也普遍较高，特别是在适应性、情绪、可接受性、（父母）能力和总压力方面。这些试点结果应指导未来的研究，探索父母/家庭因素以及在小儿CKD临床护理中减轻育儿压力和相关负担的潜在干预措施。
