628 - Ratings of Parenting Stress in Pediatric Chronic Kidney Disease

Publication Number: 628.6371

Stephen R. Hooper, University of North Carolina at Chapel Hill School of Medicine, Pittsboro, NC, United States; Peter J. Duquette, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC, United States

Background: The intensity with which stress impacts families may be more illness-specific and idiosyncratic than current research suggests. Parents of children with chronic kidney disease (CKD) may be particularly susceptible due to the dynamic nature of the disease and associated treatment demands. Prior research on parents of children with CKD has been mostly qualitative in nature (Tong et al., 2010), though one recent study showed higher rates of stress, anxiety, and depression among parents of children with CKD, especially for those with negative perceptions of their own health, more medical comorbidities for the child, and higher rates of school absences (De Bruyne et al., 2024).

Objective: The current study evaluated parenting stress in pediatric CKD relative to caregivers of healthy, typically developing children. We hypothesized that caregivers of children with CKD would experience higher levels of parenting stress as a group, and that a higher proportion of parents in the CKD group would report parenting stress levels in the clinically significant range.

Design/Methods: The patient sample consisted of 22 participants, ages 6 to 18 years, with CKD recruited from a pediatric nephrology subspecialty clinic. Participants had experienced kidney dysfunction (i.e., GFR < 75 mL/min/1.73m2 or dialysis dependent) for at least 3 months. Patients were excluded if they had a kidney transplant or had a co-morbid condition associated with severe CNS anomalies. The control group was comprised of 39 healthy children and adolescents recruited within the catchment area of the pediatric nephrology practice. Parents completed the Parenting Stress Index (PSI), yielding Child, Parent, and Total scores, as a measure of their current stress.

Results: The MANCOVA comparing the CKD and control groups on the PSI was significant (p=0.03), with follow-up ANOVAs indicating that parents in the CKD group endorsed significantly higher PSI Child Domain Scores, F(1,59)=6.28, p=0.02, ηp2=.096, than the control group. The proportion of ratings >85th percentile for PSI Child, PSI Parent, and PSI Total scores were not significant between groups.

Conclusion(s): Results suggest that parenting stress in this population is focally related to child characteristics as well as a perception by parents that the present circumstances are outside their control. These results should guide future interventions for reducing parenting stress and related burdens in the standard of care for pediatric CKD.