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慢性肾脏病患者照料者的心理困扰与生活质量:探索疾病各阶段的神经行为关联

Psychological Distress and Quality of Life in CKD Caregivers: Exploring Neurobehavioral Correlates Across Disease Stages.

作者信息

Ishran Bhoomika, Sharma Rajni, Kushwah Sunil, Dawman Lesa, Kohli H S, Ramachandran Raja, Soni Krishan, Tiewsoh Karalanglin

机构信息

Department of Paediatrics, Post Graduate Institute for Medical Education and Research, Chandigarh, India.

Department of Nephrology, Post Graduate Institute for Medical Education and Research, Chandigarh, India.

出版信息

Ann Neurosci. 2025 Aug 27:09727531251364681. doi: 10.1177/09727531251364681.

Abstract

BACKGROUND

Caregivers of children with chronic kidney disease (CKD) often face significant psychological and social challenges. This study aimed to assess the extent of psychological distress, quality of life (QOL), coping strategies and associated risk factors among caregivers and to evaluate whether these issues intensify with advanced stages of CKD.

METHODS

A cross-sectional observational study was conducted at a tertiary care centre in North India, enrolling 50 consecutive caregivers of children with CKD between July 2020 and June 2021. Participants were categorised into two groups: Early-stage CKD (Stages 1-2) and advanced-stage CKD (Stages 3-5). Caregivers were assessed using the Paediatric Renal Caregiver Burden Scale (PRCBS), Depression Anxiety Stress Scale (DASS-21), World Health Organisation Quality of Life Scale-Brief (WHOQOL-BREF) and Ways of Coping Checklist. Relevant statistical analyses were performed.

RESULTS

Caregivers of children with advanced CKD reported higher levels of psychological distress, with 88.5% experiencing moderate to severe depression, 38% anxiety and 35% stress. In contrast, caregivers of early-stage CKD children reported depression in 21%, with no cases of moderate to severe anxiety or stress. QOL scores were significantly lower and burden scores significantly higher, in the advanced CKD group. Lower socioeconomic status, reduced maternal education and low household income were linked to higher distress and poorer QOL. Problem-focused coping strategies were commonly used across both groups.

CONCLUSION

Psychosocial difficulties and caregiver burden increase with CKD severity and adversely affect QOL. Early identification and psychological support for caregivers may enhance overall outcomes for both the child and family.

摘要

背景

慢性肾脏病(CKD)患儿的照料者常常面临重大的心理和社会挑战。本研究旨在评估照料者的心理困扰程度、生活质量(QOL)、应对策略及相关风险因素,并评估这些问题是否会随着CKD病情进展而加剧。

方法

在印度北部的一家三级医疗中心开展了一项横断面观察性研究,于2020年7月至2021年6月连续纳入50名CKD患儿的照料者。参与者被分为两组:早期CKD(1-2期)和晚期CKD(3-5期)。使用儿科肾脏照料者负担量表(PRCBS)、抑郁焦虑压力量表(DASS-21)、世界卫生组织生活质量简表(WHOQOL-BREF)和应对方式清单对应照料者进行评估。进行了相关统计分析。

结果

晚期CKD患儿的照料者报告的心理困扰程度更高,88.5%经历中度至重度抑郁,38%焦虑,35%有压力。相比之下,早期CKD患儿的照料者中有21%报告有抑郁,无中度至重度焦虑或压力病例。晚期CKD组的生活质量得分显著更低,负担得分显著更高。社会经济地位较低、母亲受教育程度降低和家庭收入低与更高的困扰和更差的生活质量相关。两组均普遍采用以问题为中心的应对策略。

结论

社会心理困难和照料者负担随CKD严重程度增加而增加,并对生活质量产生不利影响。对照料者进行早期识别和心理支持可能会改善儿童和家庭的整体结局。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cfe1/12391037/e824033a006e/10.1177_09727531251364681-fig1.jpg

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