Examining Uncertainty in Illness in Parents and Children With Chronic Kidney Disease and Systemic Lupus Erythematosus: A Mediational Model of Internalizing Symptoms and Health-Related Quality of Life

  • Jennifer L. PetrongoloEmail author
  • Nataliya Zelikovsky
  • Rachel M. Keegan
  • Susan L. Furth
  • Andrea Knight


To examine if parent illness uncertainty is indirectly associated with child depression, anxiety, and HRQOL in the CKD/SLE population. Parent–child dyads (N = 31) from outpatient rheumatology and nephrology clinics included children (ages 9–18) diagnosed with CKD (Stage 1, 2, or nephrotic syndrome) or SLE. Parents completed demographic and uncertainty measures and children completed uncertainty, depression, anxiety, and HRQOL measures. This cross-sectional study examined mediational models using the percentile bootstrapping method. Parent uncertainty had an indirect effect on child depression, anxiety, and HRQOL through the mediator, child uncertainty. In other words, parents’ illness uncertainty regarding their child’s condition correlates to the child’s illness uncertainty, which then is associated with the child’s mental health and wellbeing. Reverse mediations illustrated that parent uncertainty did not mediate child uncertainty and outcome variables. Results extend previous research by examining parent and child illness uncertainty in understudied conditions (CKD/SLE) and the relationship to outcome variables commonly related to depression (e.g., anxiety and HRQOL). Findings allow health psychologists and medical personnel to understand the impact of uncertainty on the child’s wellbeing and HRQOL. Clinical implications, including using specialized interventions to address illness uncertainty, are discussed.


Chronic illness Depression Anxiety Health-related quality of life Uncertainty in illness 


Compliance with Ethical Standards

Conflict of interest

Jennifer L. Petrongolo, Nataliya Zelikovsky, Rachel M. Keegan, Susan L. Furth, and Andrea Knight declare that they have no conflict of interest.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed Consent

Informed consent and/or child assent was obtained from all individual participants included in this study.


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Authors and Affiliations

  1. 1.Department of PsychologyLa Salle UniversityPhiladelphiaUSA
  2. 2.Department of PediatricsPerelman School of Medicine at the University of Pennsylvania and the Children’s Hospital of PhiladelphiaPhiladelphiaUSA

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