Qualitative Analysis of the Psychosocial Adaptation Process in Children with Chronic Kidney Disease: Toward Effective Support During Transition from Childhood to Adulthood

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  • Aoto Haruka
    *School of Health Sciences, Tottori University Faculty of Medicine, Yonago 683-8503, Japan
  • Nakatani Hikaru
    †Tottori University Hospital, Yonago 683-8504, Japan
  • Kanayama Shunsuke
    ‡University of Shimane, Izumo 693-8550, Japan
  • Okada Shin-ichi
    †Tottori University Hospital, Yonago 683-8504, Japan
  • Fukada Mika
    *School of Health Sciences, Tottori University Faculty of Medicine, Yonago 683-8503, Japan
  • Hanaki Keiichi
    *School of Health Sciences, Tottori University Faculty of Medicine, Yonago 683-8503, Japan

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<p>Background Pediatric chronic renal disease only shows abnormal values in a urinalysis in the initial stage, and subjective signs and symptoms are rare. If adolescents with chronic renal disease face a disease crisis combined with the usual developmental crisis, this may cause psychosocial maladaptation. We analyzed psychosocial adaptation in Japanese children with chronic renal disease in order to identify factors influencing healthy adaptation.</p><p>Methods Ten children and adult patients with chronic kidney disease attending Tottori University Hospital, Japan in 2016 participated in a semi-structured interview (a modified version of the grounded theory approach) comprising questions about episodes since disease onset and thoughts/feelings at onset.</p><p>Results Twenty-four concepts extracted from the data were sorted into 5 categories. These concepts and categories were expanded on an orthogonal axis with time and self-esteem in order to establish an adaptation model for children with chronic kidney disease. Category names are as follows. (Cat. 1: Emotional impact on being informed of disease, Cat. 2: Social challenges of treatment and resulting identity diffusion, Cat. 3: Emotional conflict on school return, Cat. 4: Resilience and related factors, Cat. 5: Re-establishment of identity).</p><p>Conclusion Since pediatric chronic renal disease has few manifestations, it is difficult for patients to accept. Children facing a chronic disease crisis plus adolescent developmental crisis may show identity diffusion. In order for children to re-establish their identity and adapt to society, factors supporting resilience are important. Key factors include school life, interactions with friends, counseling by adult mentors and family acceptance. Healthcare professionals need to provide age-appropriate information on renal disease and support patients.</p>

収録刊行物

  • Yonago Acta Medica

    Yonago Acta Medica 61 (3), 166-174, 2018

    ヨナゴ・アクタ・メディカ刊行会

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