[Psychosocial care of children and adolescents with chronic kidney disease (in a 2-year period)--problems, tasks, services].

The psychosocial services provided over a period of two years to 24 children and young people with chronic renal insufficiency in various disease stages were analyzed on the basis of patient files. A total of 1475 contacts (units) were classified according to the four dimensions: (1) type of care provided, (2) problems dealt with, (3) contact persons, (4) disease stage. Variety and multitude of the individual psychosocial problems present demonstrate the scope for psychosocial activity. Supportive services (1) pertaining to the so-called disease-context (2) and, more specifically, personal contacts with the patients (3) in the dialysis stage (4) were found to prevail among the functions of the attending psychologist. Psychosocial services focussing on specific individual and/or practical issues had plainly been far more important in the care of the chronically ill children and their families, than approaches based on classical clinical psychology and psychotherapy. These findings have resulted in increased staffing for supportive services "on site" (i.e. during dialysis time), which has entailed greater latitude in the time available for dealing with relevant preventive aspects in preparing patients for dialysis and transplantation.