Improving Children's Quality of Life during Haemodialysis via Nursing Interventions

Abstract

Background: Strict dietary and lifestyle changes are necessary for children with chronic kidney disease (CKD), but little is known about their quality of life in this context. We set out to compare HRQOL among groups of children with varying degrees of chronic kidney disease (CKD) with a healthy control group.

Methods: Using the PedsQLTM Generic Core Scale, a cross-sectional evaluation of HRQOL was conducted for the following domains: physical, emotional, social, and school. Twelve children on maintenance haemodialysis or peritoneal dialysis (DIAL) and twenty-seven children with kidney transplants (TX) were included in the data set, along with twenty children with chronic renal insufficiency (CRI; creatinine >200 µmol/l). The following numbers were collected from caregivers: 20 for CRI, 17 for DIAL, and 21 for TX. Using analysis of variance (ANOVA), we compared the CKD groups; t-tests were used to compare our CKD samples to the controls.

Summary: In every subscale, children with CKD performed worse than the controls; however, the difference between the controls and children with TX was statistically significant (P<0.02). Children in the DIAL group outperformed the TX group across the board. The physical subscale showed a significant result for the analysis of covariance with number of drugs as a covariate (F = 8.95, df = 3, 53, P = 0.004). In each of the four categories, patient scores were higher than those of the proxy caregiver. Children with chronic kidney disease report a worse HRQOL compared to the healthy control group. Caregivers may find comfort in the fact that children undergoing dialysis report a higher-than-expected HRQOL. Nevertheless, it is concerning that the children of caregivers did not share their perception of better HRQOL following transplantation in this study.