Qualitative Analysis of the Psychosocial Adaptation Process in Children with Chronic Kidney Disease: Toward Effective Support During Transition from Childhood to Adulthood
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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DOI：
10.33160/yam.2018.09.004
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发表时间：
2018-09-01
影响因子：
1
通讯作者：
Hanaki, Keiichi
中科院分区：
文献类型：
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作者：
Aoto, Haruka;Nakatani, Hikaru;Hanaki, Keiichi
儿童慢性肾脏病仅在初期尿常规检查中出现异常，自觉症状和体征少见。如果患有慢性肾脏疾病的青少年面临疾病危机与通常的发育危机相结合，这可能会导致心理社会适应不良。我们分析了日本慢性肾病儿童的心理社会适应，以确定影响健康适应的因素。方法10名儿童和成人慢性肾病患者在鸟取大学医院就诊，2016年日本参加了半结构化面试（扎根理论方法的修改版本）包括关于疾病发作以来的发作和发作时的想法/感受的问题。从数据中提取的4个概念被分为5类。这些概念和类别在时间和自尊的正交轴上扩展，以建立慢性肾脏病儿童的适应模型。类别名称如下。(Cat.一曰：结论儿童慢性肾脏病临床表现少，患者难以接受。面临慢性疾病危机和青少年发展危机的儿童可能会表现出身份扩散。为了使儿童重新确立其身份并适应社会，支持复原力的因素很重要。关键因素包括学校生活、与朋友的互动、成人导师的辅导和家庭的接受。医疗保健专业人员需要提供与年龄相适应的肾病信息并支持患者。
Background Pediatric chronic renal disease only shows abnormal values in a urinalysis in the initial stage, and subjective signs and symptoms arc 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.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.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).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.