title: Parent-child and spousal relationships in families with a young child with end-stage renal disease.
abstract: BACKGROUND
  End-stage renal disease (ESRD) leads to the need for dialysis and renal transplantation (Tx). Peritoneal dialysis (PD) of young children is normally performed at home by the parents and affects the whole family. We studied the coping of families with a young child with ESRD by interviewing the parents of 19 children.
  
  
  METHODS
  The spousal and parent-child relationships were assessed by using the Psychosocial Assessment of Childhood Experiences (PACE) and the Brief Measure of Expressed Emotion, respectively. A control group of 22 families with a healthy child was used for the parent-child relationship evaluation.
  
  
  RESULTS
  The spousal relationship at the start of PD was good or fairly good in most of the families and remained good in half of the families following renal Tx. Lack of support from close relatives and renal Tx were associated with a poorer relationship quality. Almost all parents expressed much or fairly much emotional warmth towards the child throughout the study, but there was a trend towards increased criticism over time. No differences in the degree of expressed warmth or criticism were noted between the index parents and controls.
  
  
  CONCLUSIONS
  Overall, the study families appeared to cope well despite the serious illness of their child and the demands of the treatments.
authors.affiliation: Department of Pediatric Nephrology and Transplantation, Children's' Hospital, Helsinki University Central Hospital, Helsinki, Finland, hanne.laakkonen@hus.fi.
authors.forename: Hanne
authors.initials: H
authors.lastname: Laakkonen
authors.forename: Sara
authors.initials: S
authors.lastname: Taskinen
authors.forename: Kai
authors.initials: K
authors.lastname: Rönnholm
authors.forename: Christer
authors.initials: C
authors.lastname: Holmberg
authors.forename: Seija
authors.initials: S
authors.lastname: Sandberg
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D017028:Caregivers / Q000523:psychology*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D007676:Kidney Failure, Chronic / Q000523:psychology*; D008297:Male; D010287:Parent-Child Relations; D010290:Parents / Q000523:psychology*; D018454:Spouses; D013315:Stress, Psychological; D011795:Surveys and Questionnaires
references.citation: Int J Methods Psychiatr Res. 2003;12(4):182-91
references.pmid: 14657974
references.citation: Pediatr Transplant. 2004 Apr;8(2):120-5
references.pmid: 15049791
references.citation: J Adv Nurs. 2002 Jul;39(2):190-8
references.pmid: 12100663
references.citation: Br Med J. 1979 Jun 16;1(6178):1628-9
references.pmid: 380757
references.citation: Pediatr Nephrol. 2012 Dec;27(12):2293-300
references.pmid: 22832667
references.citation: Child Care Health Dev. 2010 Jul;36(4):549-57
references.pmid: 20412147
references.citation: Pediatr Nephrol. 2011 Oct;26(10):1881-92
references.pmid: 21520007
references.citation: J Consult Clin Psychol. 1978 Oct;46(5):932-46
references.pmid: 701572
references.citation: Coll Antropol. 2011 Sep;35 Suppl 2:275-80
references.pmid: 22220452
references.citation: Can J Psychiatry. 1990 Dec;35(9):726-33
references.pmid: 2282626
references.citation: J Am Acad Child Adolesc Psychiatry. 2001 Jul;40(7):847-54
references.pmid: 11437024
references.citation: Pediatr Transplant. 2004 Feb;8(1):44-51
references.pmid: 15009840
references.citation: J Pediatr Psychol. 2012 Jun;37(5):523-32
references.pmid: 22271793
references.citation: Pediatr Nephrol. 1995 Feb;9(1):87-93
references.pmid: 7742232
references.citation: Child Care Health Dev. 2011 Mar;37(2):224-32
references.pmid: 21083686
references.citation: Transpl Int. 1998;11 Suppl 1:S39-41
references.pmid: 9664940
references.citation: Pediatr Transplant. 2002 Feb;6(1):53-62
references.pmid: 11906644
references.citation: Perit Dial Int. 1996;16 Suppl 1:S551-3
references.pmid: 8728268
references.citation: J Dev Behav Pediatr. 2002 Oct;23(5):314-21
references.pmid: 12394519
references.citation: Pediatr Nephrol. 2011 Oct;26(10):1863-71
references.pmid: 21547426
references.citation: Pediatr Nephrol. 2012 Jan;27(1):145-50
references.pmid: 21786082
references.citation: Can J Psychol. 1988 Jun;42(2):173-88
references.pmid: 2458815
references.citation: J Child Psychol Psychiatry. 1998 Jan;39(1):29-46
references.pmid: 9534085
references.citation: J Child Psychol Psychiatry. 1988 Jan;29(1):79-90
references.pmid: 3350886
references.citation: Transplantation. 2011 Dec 27;92(12):1322-6
references.pmid: 22075528
references.citation: Perit Dial Int. 1997 Nov-Dec;17(6):573-80
references.pmid: 9655157
references.citation: Nephrol Nurs J. 2008 Mar-Apr;35(2):157-62
references.pmid: 18472684
references.citation: J Pediatr. 2011 Feb;158(2):251-6.e1
references.pmid: 20850763
references.citation: J Pediatr. 2005 Apr;146(4):512-7
references.pmid: 15812455
references.citation: Pediatr Nephrol. 2006 Jun;21(6):846-50
references.pmid: 16703376
references.citation: Emotion. 2010 Apr;10(2):237-49
references.pmid: 20364900
references.citation: Pediatr Nephrol. 2009 Mar;24(3):463-74
references.pmid: 18214549
references.citation: J Child Psychol Psychiatry. 1993 Sep;34(6):879-97
references.pmid: 8408373
references.citation: J Fam Nurs. 2009 May;15(2):237-63
references.pmid: 19423767
references.citation: Pediatr Nephrol. 1995 Oct;9(5):628-31
references.pmid: 8580029
references.citation: Kidney Int. 2006 Dec;70(11):1983-7
references.pmid: 16985519
references.citation: Pediatr Nephrol. 2005 Jul;20(7):849-53
references.pmid: 15834618