Analysis of the interdependence between chronic kidney disease child-parent transition readiness and the quality of life of both parties

doi:10.3969/j.issn.1674-8115.2021.12.007

Abstract

Abstract: Objective

·To investigate the interdependence between chronic kidney disease children's transition readiness assessment of children and their parents and the quality of life of both parties by using an Actor-Partner Interdependence Model.

Methods

·A convenience sample of 177 pairs of children with CKD aged 12?18 years who were hospitalized in the Nephrology Department of Shanghai Children′s Medical Center, Shanghai Jiao Tong University School of Medicine and Children′s Hospital of Shanghai, Shanghai Jiao Tong University from October 2018 to April 2021, and their parents were selected for the general information questionnaire and self-care and transition readiness and quality of life questionnaire, and a model was constructed by using AMOS 24.0 to analyze the correlations.

Results

·The assessment of transition readiness of 177 children with CKD and their parents was unsatisfactory, with item average score of 3.39±0.62 for the children and 3.31±0.63 for the parents; the item average score of quality of life for the children and parents were 75.35±15.28 and 70.27±18.56, respectively. Multiple stratified regression analysis showed that the number of school days missed within six months was a negative predictor of the child′s quality of life; duration of illness, only child or not in a family, and mother unemployment were negative predictors of the parent′s quality of life, while doctor-patient communication between the child and the parent was a positive predictor for both parties. The results of the actor-partner interdependence model showed interdependence between child and parent assessment of the child′s transition readiness and quality of life of both parties, with an actor effect between parent transition readiness and parent quality of life (B=27.76, P=0.000) and a partner effect for both child and parent (child: B=-14.91, P=0.007; parent: B=14.35, P=0.000), and in the subdimensional analysis, there were actor-partner effects of varying degrees.

Conclusion

·There is a reciprocal relationship between child′s transition readiness by the child with CKD and his or her parents and the quality of life of both parties, and health care providers need to focus on parent-child interaction during the child-parent transition and include both the child and parents in the development of a targeted transition readiness plan to improve the quality of life of both parties.

Key words: quality of life, transition readiness, chronic kidney disease, child, parent, Actor-Partner Interdependence Model

CLC Number:

R473

Si-si ZHOU, Ge-yan GONG, Jia-li MA, Wen-ying GAO, Ying ZHANG. Analysis of the interdependence between chronic kidney disease child-parent transition readiness and the quality of life of both parties[J]. JOURNAL OF SHANGHAI JIAOTONG UNIVERSITY (MEDICAL SCIENCE), 2021, 41(12): 1588-1595.

Figures/Tables 8

TrendMD

References 15

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Item	M （Q₁， Q₃）	QoL of children		QoL of parents
Item	M （Q₁， Q₃）	r value	P value	r value	P value
Child′s age/year	13 （12， 14）	0.020	0.787	0.094	0.215
Father′s age/year	41 （39， 45）	-0.005	0.945	-0.031	0.680
Mother′s age/year	39 （38， 44）	0.018	0.809	-0.008	0.914
Disease duration/month	12.00 （1.75， 48.00）	-0.257	0.001	-0.289	0.000
Absence from school during half a year/d	10 （0， 60）	-0.486	0.000	-0.128	0.089
Kind of oral medicines used/n	3 （1， 5）	-0.302	0.000	-0.147	0.051

Item	M （Q₁， Q₃）	QoL of children		QoL of parents
Item	M （Q₁， Q₃）	r value	P value	r value	P value
Child′s age/year	13 （12， 14）	0.020	0.787	0.094	0.215
Father′s age/year	41 （39， 45）	-0.005	0.945	-0.031	0.680
Mother′s age/year	39 （38， 44）	0.018	0.809	-0.008	0.914
Disease duration/month	12.00 （1.75， 48.00）	-0.257	0.001	-0.289	0.000
Absence from school during half a year/d	10 （0， 60）	-0.486	0.000	-0.128	0.089
Kind of oral medicines used/n	3 （1， 5）	-0.302	0.000	-0.147	0.051

Item	n（%）	QoL of children			QoL of parents
Item	n（%）	x±s	F/t value	P value	x±s	F/t value	P value
Gender			0.367	0.714		-1.002	0.318
Boy	112 （63.3）	75.60±15.82			69.16±18.70
Girl	65 （36.7）	74.72±14.58			72.06±18.34
Primary caregiver			0.747	0.525		1.954	0.123
Father	41 （23.2）	77.31±13.30			74.33±17.70
Mother	113 （63.8）	74.74±16.07			67.82±19.13
Grandparent	20 （11.3）	75.65±15.15			75.81±16.36
Other	3 （1.7）	64.85±15.84			67.50±6.96
Number of children in a family			2.316	0.022		2.659	0.009
One	75 （42.4）	78.35±14.40			74.48±17.86
More than one	102 （57.6）	73.01±15.68			67.10±18.54
Geographical location			－3.089	0.002		-1.861	0.064
Rural area	85 （48.0）	71.65±15.19			67.54±18.76
Urban area	92 （52.0）	78.62±14.78			72.71±18.14
Family income			3.766	0.012		1.163	0.325
<4 000 yuan	38 （21.5）	73.08±14.75			66.32±19.82
4 001‒8 000 yuan	72 （40.7）	72.58±14.81			69.80±16.50
8 001‒12 000 yuan	36 （20.3）	76.45±17.21			74.17±19.56
＞12 000 yuan	31 （17.5）	82.85±12.73			71.45±20.19
Father′s education level			3.311	0.021		1.102	0.350
Less than junior school	25 （14.1）	75.65±15.10			67.80±22.41
Junior school	70 （39.5）	71.84±15.14			67.91±14.83
High school or technical secondary school	35 （19.8）	80.34±15.86			73.33±18.77
College degree or above	47 （26.6）	78.01±14.23			72.66±21.03
Mother′s education level			2.756	0.044		1.850	0.140
Less than junior school	38 （21.5）	72.54±14.21			69.01±18.68
Junior school	62 （35.0）	72.37±14.97			66.65±17.07
High school or technical secondary school	31 （17.5）	78.05±17.60			72.27±15.47
College degree or above	46 （26.0）	79.56±14.20			74.23±18.57
Father′s occupation			0.863	0.424		1.344	0.263
Blue-collar worker	96 （54.2）	76.66±14.81			72.18±18.29
White-collar worker	74 （41.8）	73.64±15.95			67.53±19.07
Unemployment	7 （4.0）	73.45±16.18			71.96±15.43
Mother′s occupation			6.097	0.003		8.203	0.000
Blue-collar worker	71 （40.1）	79.54±14.30			76.43±16.75
White-collar worker	57 （32.2）	74.51±14.20			68.40±19.08
Unemployment	49 （27.7）	69.96±16.50			63.37±17.93

Item	n（%）	QoL of children			QoL of parents
Item	n（%）	x±s	F/t value	P value	x±s	F/t value	P value
Gender			0.367	0.714		-1.002	0.318
Boy	112 （63.3）	75.60±15.82			69.16±18.70
Girl	65 （36.7）	74.72±14.58			72.06±18.34
Primary caregiver			0.747	0.525		1.954	0.123
Father	41 （23.2）	77.31±13.30			74.33±17.70
Mother	113 （63.8）	74.74±16.07			67.82±19.13
Grandparent	20 （11.3）	75.65±15.15			75.81±16.36
Other	3 （1.7）	64.85±15.84			67.50±6.96
Number of children in a family			2.316	0.022		2.659	0.009
One	75 （42.4）	78.35±14.40			74.48±17.86
More than one	102 （57.6）	73.01±15.68			67.10±18.54
Geographical location			－3.089	0.002		-1.861	0.064
Rural area	85 （48.0）	71.65±15.19			67.54±18.76
Urban area	92 （52.0）	78.62±14.78			72.71±18.14
Family income			3.766	0.012		1.163	0.325
<4 000 yuan	38 （21.5）	73.08±14.75			66.32±19.82
4 001‒8 000 yuan	72 （40.7）	72.58±14.81			69.80±16.50
8 001‒12 000 yuan	36 （20.3）	76.45±17.21			74.17±19.56
＞12 000 yuan	31 （17.5）	82.85±12.73			71.45±20.19
Father′s education level			3.311	0.021		1.102	0.350
Less than junior school	25 （14.1）	75.65±15.10			67.80±22.41
Junior school	70 （39.5）	71.84±15.14			67.91±14.83
High school or technical secondary school	35 （19.8）	80.34±15.86			73.33±18.77
College degree or above	47 （26.6）	78.01±14.23			72.66±21.03
Mother′s education level			2.756	0.044		1.850	0.140
Less than junior school	38 （21.5）	72.54±14.21			69.01±18.68
Junior school	62 （35.0）	72.37±14.97			66.65±17.07
High school or technical secondary school	31 （17.5）	78.05±17.60			72.27±15.47
College degree or above	46 （26.0）	79.56±14.20			74.23±18.57
Father′s occupation			0.863	0.424		1.344	0.263
Blue-collar worker	96 （54.2）	76.66±14.81			72.18±18.29
White-collar worker	74 （41.8）	73.64±15.95			67.53±19.07
Unemployment	7 （4.0）	73.45±16.18			71.96±15.43
Mother′s occupation			6.097	0.003		8.203	0.000
Blue-collar worker	71 （40.1）	79.54±14.30			76.43±16.75
White-collar worker	57 （32.2）	74.51±14.20			68.40±19.08
Unemployment	49 （27.7）	69.96±16.50			63.37±17.93

Independent variable	Assignment method
Number of children in a family	One=0； More than one=1
Geographical location	Rural area=0； Urban area=1
Family income	< 4 000 yuan=1； 4 001－8 000 yuan=2； 8 001－12 000 yuan=3；＞12 000 yuan=4
Father′s education level	Less than junior school= （0， 0， 0）； Junior school= （1， 0， 0）； High school or technical secondary school = （0， 1， 0）； College degree or above= （0， 0， 1）
Mother′s education level	Less than junior school= （0， 0， 0）； Junior school= （1， 0， 0）； High school or technical secondary school = （0， 1， 0）； College degree or above= （0， 0， 1）
Mother′s occupation	Blue-collar worker= （1， 0）； White-collar worker= （0， 0）； Unemployment= （0， 1）