title: Renal replacement therapy for children: a family decision.
abstract: Although Anne had many complex health issues and experienced considerable support from her extended family, she wanted freedom from the restrictions posed by peritoneal dialysis. Her quality of life changed after transplantation, with more opportunities to engage in leisure activities, ability to travel, a less restricted diet, and an improved self-image. She required fewer treatments, surgeries, and hospitalizations. She left behind the role of sick child and took up a role more like a healthy child. During the disease and decision-making process, Anne learned coping mechanisms, allowing her to gain autonomy to make decisions. The case study illustrates both the need to listen to children as well as to care for the entire family. The nursing management of this child and her family was continually changing, and multiple strategies were used to support the family. The nurse came to understand the roles of family members in constant change, the sources of their resources, and foci of tensions. Based on this knowledge, the nurse can act by mobilizing resources, strengthening the confidence of family members, and helping them develop coping mechanisms. In conclusion, care of the ill child must be family-centered. Stresses on the family have an impact on the child and vice versa. The potential to influence the quality of life of both the child and the family is considerable.
authors.affiliation: University of São Paulo at Ribeirão Preto College of Nursing, WHO Collaborating Centre for Nursing Research Development, Ribeirão Preto, São Paulo, Brasil. smmrocha@eerp.usp.br
authors.forename: Semiramis Melani Melo
authors.initials: SM
authors.lastname: Rocha
authors.forename: Carolina Camilo
authors.initials: CC
authors.lastname: Correia
authors.forename: Anita
authors.initials: A
authors.lastname: Molzahn
authors.forename: Lucila Castanheira
authors.initials: LC
authors.lastname: Nascimento
mesh_terms: D000015:Abnormalities, Multiple / Q000523:psychology* / Q000628:therapy; D002348:Carpal Bones / Q000002:abnormalities; D002648:Child; D003657:Decision Making; D005190:Family / Q000523:psychology*; D005260:Female; D006344:Heart Septal Defects, Atrial / Q000523:psychology / Q000628:therapy; D006801:Humans; D016031:Liver Transplantation / Q000523:psychology*; D008591:Meningomyelocele / Q000523:psychology / Q000628:therapy; D010342:Patient Acceptance of Health Care / Q000523:psychology*; D010530:Peritoneal Dialysis / Q000523:psychology*; D011788:Quality of Life / Q000523:psychology