Kronik Böbrek Yetmezliği Hastası Çocuğa Sahip Ebeveynlerde Kaygı, Başetme ve Sosyal Destek

Abstract

Amaç: Araştırma kronik böbrek yetmezliği hastası çocuğa sahip ebeveynlerin kaygı düzeylerini, başetme tutumlarını, sosyal destek sistemlerini ve bunlar arasındaki ilişkiyi incelemek amacıyla gerçekleştirilmiştir.

Gereç ve Yöntem: Çalışma Hacettepe Üniversitesi Çocuk Hastanesi Nefroloji Polikliniğine başvuruda bulunan 180 kronik böbrek yetmezliği hastası çocuğun ebeveynleri ile planlanmıştır. Veri toplama aracı olarak sosyodemografik bilgi formu, sürekli - durumluk kaygı envanteri ile başetme tutumlarını değerlendirme ölçeğinin kısa formu kullanılmıştır. 

Bulgular: Cinsiyet açısından annelerin zihni dağıtma, eğitim durumu açısından herhangi bir okul mezunu olmayanların inkâr odaklı başetme yolunu kullandıkları bulunmuştur. Hastalığın ikinci aşamasında olan çocukların ebeveynlerinin sürekli kaygı puanı en yüksektir. Tedavi sürecinde çevresinden sosyal destek alan ebeveynlerin başetme stratejileri incelendiğinde olumlu yeniden yorumlama, kabullenme, mizah ve duygusal destek kullanımı gibi sorun odaklı başetme stillerine daha fazla başvurdukları görülmektedir. Bunun yanında çevrelerinden bu desteği alamayan ebeveynlerin ise kendini suçlama, madde kullanımı ve durumluk kaygı puanları yüksek bulunmuştur.

Sonuç: Sosyal destek mekanizmalarını daha iyi kullanan kronik böbrek yetmezliği hastası çocuğa sahip ebeveynler bu süreçte diğer ebeveynlere göre daha başarılı olarak kabul edilen sorun odaklı başetme stratejilerini kullanmaktadır. 

Keywords

• Ebeveyn,Kronik Böbrek Yetmezliği,Kaygı,Anksiyete,Başetme,Sosyal Destek

Anxiety, Coping and Social Support Among Parents Who Have Children with Chronic Kidney Disease

Abstract

Objective: Present study has been conducted to investigate anxiety levels, coping strategies, social support systems among parents who have children with chronic kidney disease and interrelations among the three indicators.

Methods: This study has been planned among parents of 180 children with a chronic kidney disease being admitted to Hacettepe University, Children's Hospital, Nephrology Polyclinic. Sociodemographic information form, state & trait anxiety inventory and short form of the assessment scale for coping strategies have been employed as data gathering tools.

Results: With respect to gender it was detected that mothers resorted to selfdistraction coping strategy and with respect to educational level, parents with no formal educational background resorted to denial. Trait anxiety score was the highest among parents whose children were in the second stage of disease. As the coping strategies among parents receiving social support in the treatment process was examined, it surfaced that positive reframing, acceptance, humor and use of emotional support and similar problem-focused coping strategies were more frequently opted for. Contrary to that, it was identified that among parents receiving no social support from their relatives, scores of self-blame, substance use and state anxiety were relatively higher.

Conclusion: At the end of this study it was concluded that parents having children with a chronic kidney disease were more effective in utilizing social support mechanisms as a problem-focused coping strategy when compared to the other group of parents.

Keywords

• Parent,chronic kidney disease,anxiety,coping,social support

References

1. 1. Moreira JM, Soares CMBM, Teixeira AL, e Silva ACS, Kummer AM. Anxiety, depression, resilience and quality of life in children and adolescents with pre-dialysis chronic kidney disease. Pediatric Nephrology 2015; 30(12): 2153-2162.
2. 2. Bakewell AB, Higgins RM, Edmunds ME. Quality of life in peritoneal dialysis patients: decline over time and association with clinical outcomes. Kidney Int 2002; 61(1): 239-248.
3. 3. Harambat J, vanStralen KJ, Kim JJ, Tizard EJ. Epidemiology of chronic kidney disease in children. Pediatr Nephrol 2011; 27(3): 363-373.
4. 4. Gerson AC, Butler R, Moxey-Mims M, et al. Neurocognitive outcomes in children with chronic kidney disease: Current findings and contemporary endeavors. Ment Retard Dev Disabil Res Rev 2006; 12(3): 208-215.
5. 5. Kelly, MM. Assessment of life after prematurity in 9- to 10-year old children. The American Journal of Maternal Child Nursing 2013; 39(1): 26-32.
6. 6. Copelovitch L, Warady BA, Furth SL. Insights from the chronic kidney disease in children (CKiD) study. Clinical Journal of the American Society of Nephrology 2011; 6(8): 2047-2053.
7. 7. Marciano RC, Soares CMB, Diniz JSS, et al. Behavioral disorders and low quality of life in children and adolescents with chronic kidney disease. Pediatric Nephrology 2011; 26(2): 281-290.
8. 8. Levey AS, Eckardt KU, Tsukamoto Y, et al. Definition and classification of chronic kidney disease: A position statement from kidney disease: Improving global outcomes (KDIGO). Kidney Int 2005; 67(6): 2089-2100.

9. 9. Tsai TC, Liu SI, Tsai JD, Chou LH. Psychosocial effects on caregivers for children on chronic peritoneal dialysis. Kidney Int 2006; 70(11): 1983-1987.
10. 10. Aldridge, MD. How do families adjust to having a child with chronic kidney failure? A systematic review. Nephrol Nurs J 2008; 35(2): 157-162.
11. 11. Çıgrıkçı H, Kronik Hastalığı Nedeniyle Devamlı Takip Edilmekte Olan Çocukların Annelerinin Sosyodemografik Özellikleri ve Annelerin Depresyon Prevalansı. İstanbul: Dr. Sadi Konuk Eğitim ve Araştırma Hastanesi Aile Hekimliği Yayımlanmamış Uzmanlık Tezi, 2007.
12. 12. Spielberger CD. Theory and research anxiety. In: Spielberger, CD (ed). Anxiety and Behavior. New York: Academic Press; 1966: 3-20.
13. 13. Öner N, Le Compte A, State and Trait Anxiety Inventory Manual. İstanbul: Boğaziçi University Press, 1985.
14. 14. Çelik G, Annagur BB, Yılmaz M, Demir T, Kara F. Are sleep and life quality of family caregivers affected as much as those of hemodialysis patients. General Hospital Psychiatry 2012; 34(5): 518-524.
15. 15. Cohen S, Underwood LG, Gottlieb BH, Social Support Measurement and Intervention: A Guide for Health and Social Scientists. New York: Oxford Press, 2000.
16. 16. Lazarus RS, Patterns of Adjustment. New York: McGraw-Hill Book Company, 1976: 401-402.
17. 17. Lazarus RS. Emotions and interpersonal relationship: Toward a person-centered conceptualization of emotions and coping. Journal of Personality 2006; 74(1): 9-46.
18. 18. Rohde P, Lewinsohn PM, Tilson M, Seeley JR. Dimensionality of coping and its relation to depression. J Pers SocPsychol 1990; 58(3): 499-511.
19. 19. Shimoyama S, Hirakawa O, Yahiro K, Mizumachi T, Schreiner A, Kakuma T. Health-related quality of life and caregiver burden among peritoneal dialysis patients and their family caregivers in Japan. Japan Perit Dial Int 2003; 23(Suppl 2): S200-S205.
20. 20. Yılmaz M. (2002). Nurses’ role in assisting the patient diagnosed with chronic kidney disease and patient’s family. Çınar Journal 2002; 8(2): 29-35.
21. 21. Kostoff RN, Patel U. Literature-related discovery and innovation: Chronic kidney disease. Technological Forecasting and Social Change 2015; 91: 341-351.
22. 22. Christensen AJ, Ehlers SL, Raichle KA, Bertolatus JA, Lawton WJ. Predicting change in depression following renal transplantation: Effect of patient coping preferences. Health Psychology 2000; 19(4): 348-353.
23. 23. Takaki J, Nishi T, Shimoyama H, et al. Interactions among a stressor, self-efficacy, coping with stress, depression, and anxiety in maintenance hemodialysis patients. Behavioral Medicine 2003; 29(3): 107-112.
24. 24. Spielberger CD, STAI Manual for the State-Trait Anxiety Inventory: Self-Evaluation Questionnaire. USA: Consulting Psychologist Press, 1970: 1-24.
25. 25. Carver CS, Scheier MF, Weintraub JK. Assessing coping strategies: A theoretically based approach. Journal of Personality and Social Psychology 1989; 56(2): 267-283.
26. 26. Carver CS. You want to measure coping but your protocol’too long: Consider the brief cope. International Journal of Behavioral Medicine 1997; 4(1): 92-100.
27. 27. Tuna ME, Cross-cultural Differences in Coping Strategies as Predictors of University Adjustment of Turkish and US Students. Unpublished PhD dissertation. Ankara: Middle East Technical University (METU), 2003.
28. 28. Alpay H, Yıldız N, Özçay S. Etiological assessment in chronic kidney failure. Turkish Nephrology and Transplantation Journal 2002; 11(3), 144-148.
29. 29. Alnazly EK. Burden and coping strategies among Jordanian caregivers of patients undergoing hemodialysis. Hemodialysis International 2016; 20(1): 84-93.
30. 30. Kumar D, Sanders L, Perrin EM, et al. Parental understanding of infant health information: Health literacy, numeracy, and the Parental Health Literacy Activities Test (PHLAT). Academic Pediatrics 2010; 10(5): 309-316.
31. 31. Wallace LS, Keenum AJ, De Voe JE, Bolon SK, Hansen JS. Women’s understanding of different dosing instructions for a liquid pediatric medication. Journal of Pediatric Health Care 2012; 26(6): 443-450.
32. 32. De Paula ES, Nascimento LC, Rocha SM. Roles assessment in families of children with chronic renal failure on peritoneal dialysis. Int J Nurs Pract 2008; 14(3): 215-220.
33. 33. Swallow V, Lambert H, Santacroce S, MacFadyen A. Fathers and mothers developing skills in managing children's long‐term medical conditions: How do their qualitative accounts compare?. Child: Care, Health and Development 2011; 37(4): 512-523.
34. 34. Atagün İM, Balaban DÖ, Atagün Z, Elagöz M, Özpolat YA. Caregive burden in chronic diseases. Modern Approaches in Psychiatry 2011; 3(3): 513-552.
35. 35. Harrington M. Health literacy in children with chronic kidney disease and their caregivers. Nephrology Nursing Journal 2015; 42(1), 53-58.
36. 36. Hooper SR, Duquette PJ, Icard P, Wetherington CE, Harrell W, Gipson DS. (2009). Social‐behavioural functioning in paediatric chronic kidney disease. Child: Care, Health and Development 2009; 35(6): 832-840.
37. 37. Cimete G. Stress factors and coping strategies of parents with children treated by hemodialysis: A qualitative study. J Pediatr Nurs 2002; 17(4): 297-306.
38. 38. Tong A, Lowe A, Sainsbury P, Craig JC. Parental perspectives on caring for a child with chronic kidney disease: An in‐depth interview study. Child: Care, Health and Development 2010; 36(4): 549-557.
39. 39. Karabulutlu E, Tan M, Erdem N, Okanlı A. Stress coping and social support among hemodialyses patients. Journal of Anatolia Nursing and Health Sciences 2005; 8(3): 56-66.
40. 40. Zelikovsky N, Schast AP, Jean-Francois D. Parent stress and coping: Waiting for a child to receive a kidney transplant. Journal of Clinical Psychology in Medical Settings 2007; 14(4): 320-329.
41. 41. Dabrowska A, Pisula E. Parenting stress and coping styles in mothers and fathers of pre‐school children with autism and Down syndrome. Journal of Intellectual Disability Research 2010; 54(3): 266-280.
42. 42. Shahgholian N, Yousefi H. Supporting hemodialysis patients: A phenomenological study. Iranian Journal of Nursing and Midwifery Research 2015; 20(5): 626-633.
43. 43. Cohen, SD, Sharma T, Acquaviva K, Peterson RA, Patel SS, Kimmel PL. Social support and chronic kidney disease: An update. Adv Chronic Kidney D 2007; 14(4): 335-344.
44. 44. Plantiga LD, Fink NE, Harrington-Levey R, et al. Association of social support with outcomes in incident dialysis patients. Clin J Am Soc Nephrol 2010; 5(8): 1480-1488.
45. 45. Patel SS, Peterson RA, Kimmel PL. The impact of social support on end-stage renal disease. Semin Dial 2005;18(2): 98-102.
46. 46. Gray DE, Holden WJ. Psycho-social well-being among the parents of children with autism. Australia and New Zealand Journal of Developmental Disabilities 1992; 18(2): 83-93.
47. 47. Chan KY, Yip T, Yap DY, et al. Enhanced psychosocial support for caregiver burden for patients with chronic kidney failure choosing not to be treated by dialysis or transplantation: A pilot randomized controlled trial. American Journal of Kidney Diseases 2016; 67(4): 585-592.
48. 48. Grapsa E, Pantelias K, Ntenta E, et al. Caregivers’ experience in patients with chronic diseases. Social Work in Healthcare 2014; 53(7): 670-678.