Vida Francis Negrete

Kidney transplantation in children: Psychosocial follow-up study on child and family*

In 35 children treated for end-stage kidney disease with hemodialysis and transplantation, the psychosocial attributes of child and family were studied for their impact on long-term rehabilitation. Data were processed by a computerized system. The childrens personalities and family function, although severely stressed during acute treatment, usually had returned to preillness equilibrium within a year and were comparable to a control group of other chronically ill children. Fear of rejection of the kidney and damaged self-esteem were prominent. Personality tests confirmed clinical diagnoses concerning psychosocial pathology and occasionally preceded such diagnosis. Personality testing prior to treatment of end-stage kidney disease may aid in predicting rehabilitation potential.

Experiences with children and their families during extended hemodialysis and kidney transplantation.

Psychologic responses of patients, family, and hospital staff to hemodialysis and renal transplantation.

How do Nurses Expand Their Roles in Well Child Care

A noted team of researchers analyzes the extent to which pediatric nurses in extended roles include social, emotional, and behavioral issues in well child conferences with mothers.

Noncompliance in children with renal transplants

Fourteen patients (13 of them adolescents) interrupted immunosuppressive treatment following renal transplantation. Twelve were girls and two were boys. Six subsequently lost their allografts and eight had impaired renal function. Noncompliance was suspected when diminution in cushingoid features, unexplained weight loss, or changes in renal function occurred. Noncompliance was comfirmed by interview with psychosocial staff. Available psychosocial data from family interview and personality test obtained earlier as part of systematic follow-up study were analyzed to explore the reasons for noncompliance. Non compliant patient families had lower incomes, more fatherless households, and comunication difficulties within the family and with the medical establishment. Using a stepwise discriminant analysis, a discriminant function was derived which selected 13 of 14 noncompliant patients. Noncompliance may be a preventable cause of allograft failure. These data can aid in identifying high-risk patients and planning intervention programs.