title: Psychosocial adjustment and quality of life after renal transplantation in early childhood.
abstract: Psychosocial adjustment and quality of life has been reported good in children after a successful renal transplantation (Tx). There are, however, few reports of using standardized methods in evaluating these issues, particularly in small children. We investigated the psychosocial adjustment in 32 children at school age (mean 9.6 +/- 1.6), who had received a renal Tx under the age of 5 yr, using the Achenbach Child Behavior Checklist with data collected from both parents (CBCL) and teachers (CBCL-TRF). Health-related quality of life (HRQOL) was assessed by interviewing the children using a 17-dimensional (17D) health-related measure and compared to HRQOL of 244 normal school children. The effect of additional diseases and comorbidity on psychosocial adjustment and HRQOL was assessed. The total scores on the CBCL did not differ from normative samples of healthy children. However, somatic complaints and social problems were reported more frequently in boys, and attention problems in both boys and girls. Patients with pathological scores had significantly more comorbidity (p = 0.03) and were more often attending a special school (p = 0.007) than patients with normal scores. The global 17D HRQOL index was significantly lower than measured in healthy controls (94 +/- 5 for controls and 85 +/- 7 for patients, p < 0.0001). It is of crucial importance to further minimize the risk factors leading to comorbidity in children after Tx. HRQOL assessment by the children themselves can be used to direct interventions and support the children's psychosocial adjustment.
authors.affiliation: Pediatric Nephrology and Transplantation, Hospital for Children and Adolescents, University of Helsinki, Helsinki, Finland. erik.qvist@helsinki.fi
authors.forename: Erik
authors.initials: E
authors.lastname: Qvist
authors.forename: Vesa
authors.initials: V
authors.lastname: Närhi
authors.forename: Marjo
authors.initials: M
authors.lastname: Apajasalo
authors.forename: Kai
authors.initials: K
authors.lastname: Rönnholm
authors.forename: Hannu
authors.initials: H
authors.lastname: Jalanko
authors.forename: Fredrik
authors.initials: F
authors.lastname: Almqvist
authors.forename: Christer
authors.initials: C
authors.lastname: Holmberg
mesh_terms: D000367:Age Factors; D019958:Attention Deficit and Disruptive Behavior Disorders / Q000523:psychology; D001294:Attitude to Health; D002648:Child; D002652:Child Behavior; D005260:Female; D006801:Humans; D016030:Kidney Transplantation / Q000523:psychology*; D008297:Male; D010290:Parents; D011788:Quality of Life; D012649:Self Concept; D012737:Sex Factors; D012917:Social Adjustment; D012919:Social Behavior; D012944:Social Support; D018709:Statistics, Nonparametric; D013663:Teaching