Pediatric Nephrology

, Volume 2, Issue 4, pp 460–465 | Cite as

Psychosocial characteristics and coping skills in children maintained on chronic dialysis

  • Andrew S. Brem
  • Francine S. Brem
  • Margaret McGrath
  • Anthony Spirito
Original Article


Psychosocial character traits and coping skills were examined in 12 children with end-stage renal failure. Six of the children were maintained on in-center hemodialysis and 6 were treated with home peritoneal dialysis. All of the patients felt a lack of ability to control their lives. The incidence of anxiety, depression, and hostility did not appear to vary from a population of healthy adolescents. Personal and social adjustment scores were, on average, on the 20th percentile. Coping skills appeared to be most influenced by the mode of dialysis treatment. Home peritoneal dialysis patients utilized self-reliance as a coping process more often than their counterparts on hemodialysis. We conclude that children maintained on chronic dialysis therapy demonstrate reasonable psychological adjustment with some differences in social and emotional functioning when compared with healthy children, and that the type of treatment chosen may influence the development of certain coping skills.

Key words

Chronic dialysis Adolescent development 


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Maher BA, Lamping DL, Dickinson CA, Murawski BJ, Olivier DC, Santiago GC (1983) Psychosocial aspects of chronic hemodialysis. Kidney Int 23: S50-S57Google Scholar
  2. 2.
    Kline SA, Burton HJ, Kaplan DeNour A, Bolley H (1985) Patient's self-assessment of stressors and adjustment to hemodialysis and CAPD. Perit Dial Bull 5: 36–39Google Scholar
  3. 3.
    Evans RW, Mannien DL, Garrison LP, Hart LG, Blagg CR, Gutman RA, Hull AR, Lowrie EG (1985) The quality of life of patients with end-stage renal disease. N Engl J Med 312: 553–559Google Scholar
  4. 4.
    Orr DP, Weller SC, Satterwhite B, Pless IB (1984) Psychosocial implications of chronic illness in adolescence. J Pediatr 104: 152–157Google Scholar
  5. 5.
    Mattson A (1972) Long-term physical illness in childhood: a challenge to psychosocial adaptation. Pediatrics 50: 801–811Google Scholar
  6. 6.
    Kellerman J, Zeltzer L, Ellenberg L, Drash J, Rigler D (1980) Psychosocial effects of illness in adolescence. I. Anxiety, self esteem, and perception of control. J Pediatr 97: 126–131Google Scholar
  7. 7.
    Spirito A, Russo DC, Masek BJ (1984) Behavioral interventions and stress management training for hospitalized adolescents and young adults with cystic fibrosis. Gen Hosp Psychiatry 6: 211–218Google Scholar
  8. 8.
    Frydman M (1979) Implications of cystic fibrosis for health services and the afflicted. Soc Sci Med 13A: 147–150Google Scholar
  9. 9.
    Brem AS, Toscano AM (1984) Continuous-cycling peritoneal dialysis for children: an alternative to hemodialysis. Pediatrics 74: 254–258Google Scholar
  10. 10.
    Nowicki S, Strickland BR (1973) A locus of control scale for children. J Consult Clin Psychol 40: 148–154Google Scholar
  11. 11.
    Piers EY (1969) Manual for The Piers-Harris Childrens Self-Concept Scale. Western Psychological Services, Los AngelesGoogle Scholar
  12. 12.
    Gayton WF, Friedman SB, Tavormina JF, Tucker F (1977) Children with cystic fibrosis. I. Psychological test findings of patients, siblings, and parents. Pediatrics 59: 888–894Google Scholar
  13. 13.
    Cairns NU, Clark GM, Smith SD, Lansky SB (1979) Adaptation of siblings to childhood malignancy. J Pediatr 95: 484–487Google Scholar
  14. 14.
    Zuckerman M, Lubin B (1965) Manual for the Multiple Affect Adjective Checklist. EDITS Publishers, San DiegoGoogle Scholar
  15. 15.
    Ford CB, Castelnuovo-Tedesco P (1977) Hemodialysis and renal transplantation-psychopathological reactions and their management. In: Wittkower ED, Warnes H (eds) Psychosomatic medicine: its clinical applications. Harper and Row, New York, pp 74–83Google Scholar
  16. 16.
    Kaplan De-Nour A (1976) The psychiatric, aspects of renal hemodialysis. In: Howells JG (ed) Modern perspectives in the psychiatric aspects of surgery. Brunner/Mazel, New York, pp 343–375Google Scholar
  17. 17.
    Hamburg B (1983) Chronic illness. In: Levine MD, Carey WB, Crocker AC, Gross RT (eds) Developmental-behavioral pediatrics. Saunders, Philadelphia, pp 455–463Google Scholar
  18. 18.
    Thorpe LP, Clark WW, Tiegs EW (1953) Manual California Test of Personality, McGraw-Hill, New YorkGoogle Scholar
  19. 19.
    Patterson JM, McCubbin HI (1983) A-Cope: adolescent coping orientation for problem experiences. University of Wisconsin, MadisonGoogle Scholar
  20. 20.
    Berman SJ (1980) Adolescent coping with cancer: the issue of control. American Psychological Association, TorontoGoogle Scholar
  21. 21.
    Langer EJ, Rodin J (1976) The effects of choice and enhanced personal responsibility for the aged: a field study in the institutionalized setting. J Pers Soc Psychol 34: 191–199Google Scholar
  22. 22.
    Zeltzer L, Kellerman J, Ellenberg L, Drash J, Rigler D (1980) Psychologic effects of illness in adolescence. II. Impact of illness in adolescents-crucial issues and coping styles. J Pediatr 97: 132–138Google Scholar
  23. 23.
    Lazarus RS (1981) The costs and benefits of denial. In: Spinetta JJ, Deasy-Spinetta P (eds) Living with childhood cancer. Mosby, St. Louis, pp 50–67Google Scholar
  24. 24.
    Perrin EC, Gerrity PS (1984) Development of children with a chronic illness. Pediatr Clin North Am 31: 19–31Google Scholar

Copyright information

© IPNA 1988

Authors and Affiliations

  • Andrew S. Brem
    • 1
  • Francine S. Brem
    • 1
  • Margaret McGrath
    • 1
  • Anthony Spirito
    • 2
  1. 1.Division of Pediatric NephrologyRhode Island Hospital, Brown University Program in MedicineProvidenceUSA
  2. 2.Division of Child and Family PsychiatryRhode Island Hospital, Brown University Program in MedicineProvidenceUSA

Personalised recommendations