title: Impact of age at onset for children with renal failure on education and employment transitions.
abstract: Previous medical research has shown that children with end-stage renal failure experience delay or underachievement of key markers of transition to adulthood. This article analyses 35 qualitative interviews with end-stage renal failure patients, aged 20-30 years, first diagnosed at 0-19 years of age, to explore how far delayed or underachievement in education and employment is related to their age at onset of end-stage renal failure. This study shows how unpredictable failures of renal replacement therapies, comorbidities and/or side effects of treatment in the early life course often coincided with critical moments for education and employment. Entering school, college, work-related training or employment, and disclosing health status or educational underachievement to an employer, were particularly critical, and those who were ill before puberty became progressively more disadvantaged in terms of successful transition into full-time employment, compared with those first diagnosed after puberty.
authors.affiliation: University of Surrey, UK m.h.lewis@ntlworld.com.
authors.forename: Helen
authors.initials: H
authors.lastname: Lewis
authors.affiliation: University of Surrey, UK.
authors.forename: Sara
authors.initials: S
authors.lastname: Arber
mesh_terms: D000293:Adolescent; D041923:Adolescent Development; D000328:Adult; D017668:Age of Onset; D002648:Child; D002657:Child Development; D015897:Comorbidity; D017281:Cost of Illness; D030881:Disclosure; D004522:Educational Status; D004651:Employment; D004739:England; D006801:Humans; D007407:Interviews as Topic; D007676:Kidney Failure, Chronic / Q000453:epidemiology / Q000628:therapy*; D016030:Kidney Transplantation / Q000009:adverse effects; D008016:Life Change Events; D036301:Qualitative Research; D006435:Renal Dialysis / Q000009:adverse effects; D017582:Renal Replacement Therapy / Q000009:adverse effects; D011795:Surveys and Questionnaires; D013995:Time; D055815:Young Adult
keywords: chronic illness; dialysis; puberty; transition; transplant