Outcome after renal transplantation. Part II: quality of life and psychosocial adjustment.
Knowledge of health-related quality of life (QOL) and psychosocial adjustment (PA) in children after renal transplantation (RTPL) is limited. QOL and PA were evaluated by standardized tests in patients after RTPL. Thirty-seven children of median age 14.5 years (range 6.5-17 years) were investigated a mean 4.5 years (range 0.5-12.8 years) after RTPL. Child- and parent-rated QOL was evaluated with the Child Quality of life Questionnaire of The Netherlands Organization for Applied Scientific Research Academical Medical Centre (TNO-AZL). PA was assessed by the Child Behaviour Checklist (CBCL) providing parental reports of a child's behaviour. In patients' self-ratings, the QOL dimension physical complaints (P < 0.0005) scored significantly better than that of healthy controls, whereas the dimension positive emotional functioning was impaired (P = 0.02). Parents rated motor functioning (P = 0.002), autonomy (P = 0.01), cognition (P = 0.04) and positive emotions (P < 0.0005) as significantly impaired. Parents also assessed PA significantly (P = 0.02) impaired with regard to internalizing behaviour. Dialysis duration, young age at RTPL, living-related donation, steroid treatment, adverse family relationships and maternal distress had a significantly negative impact on QOL and PA (P < 0.05). Patients rated QOL higher than did healthy controls. Parents evaluated their children's QOL and PA more pessimistically than did the patients themselves. Both illness-related variables and family environment played an important role.
Falger
Jutta
J
Nephrology Unit, University Children's Hospital, Steinwiesstrasse 75, Zurich, Switzerland.
Landolt
Markus A
MA
Latal
Bea
B
Rüth
Eva M
EM
Neuhaus
Thomas J
TJ
Laube
Guido F
GF
D000223:Adaptation, Psychological; D000293:Adolescent; D002648:Child; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000453:epidemiology / Q000523:psychology* / Q000601:surgery*; D016030:Kidney Transplantation / Q000523:psychology* / Q000706:statistics & numerical data; D008297:Male; D000297:Psychology, Adolescent; D002666:Psychology, Child; D011788:Quality of Life; D011795:Surveys and Questionnaires; D016896:Treatment Outcome