Family functioning and quality of life among children with nephrotic syndrome during the first pandemic wave

Pediatr Nephrol. 2023 Sep;38(9):3193-3198. doi: 10.1007/s00467-022-05809-6. Epub 2022 Dec 2.

Abstract

Background: During the SARS-CoV-2 global pandemic, one of the longest lockdowns worldwide occurred in Ontario, Canada, during the first wave. For parents and children managing care at home and at risk for COVID-19, the impact on their psychosocial functioning is unknown.

Methods: A total of 122 families of children aged 2-18 years were enrolled as part of the prospective cohort of childhood nephrotic syndrome and completed a survey during the first wave of the pandemic (August 21-December 10), 2020. In a subset, 107 families had data available pre-pandemic to assess change. Validated measures included the McMaster Family Assessment Device (FAD) for parents and children ≥ 12 years for family functioning, the Patient Health Questionnaire for Depression and Anxiety (PHQ-4) for both parent and child, and Pediatric Quality of Life Inventory (PEDSQL™-V4) for children only. Scores were compared using Student's t-test or the Mann-Whitney U test, as appropriate.

Results: Among the 107 children, 71% were male with a mean age of 9 years old at the time of questionnaire completion, and the mean age of parents was 41 years old. Parents and children reported that family functioning improved during COVID (parent: p < 0.01; child: p = 0.05). Children's overall HRQOL declined (p = 0.04), specifically increased sleep disruption (p = 0.01). Increasing child age was associated with a greater sleep disruption (β = - 1.6 [IQR: - 2.6, - 0.67]) and a related decrease in QOL (β = - 1.0 [IQR: - 1.7, - 0.2]), adjusted for sex.

Conclusions: Despite the positive effects of family dynamics during the first wave, there were negative effects of sleep disruptions and reduced quality of life in children, especially among older children. A higher resolution version of the Graphical abstract is available as Supplementary information.

Keywords: COVID-19; Chronic disease; Family functioning; Nephrotic syndrome; Quality of life; Well-being.

MeSH terms

  • Adolescent
  • Adult
  • COVID-19* / epidemiology
  • Child
  • Communicable Disease Control
  • Female
  • Humans
  • Male
  • Nephrotic Syndrome* / epidemiology
  • Pandemics
  • Parents / psychology
  • Prospective Studies
  • Quality of Life / psychology
  • SARS-CoV-2
  • Surveys and Questionnaires