FAYER, A. A. M.. Repercussões emocionais e qualidade de vida das crianças e adolescentes em hemodiálise ou transplante renal [Emotional repercussions and quality of life for children and adolescents undergoing hemodialysis or kidney transplantation]. Doctoral Thesis – Universidade Federal de São Paulo (UNIFESP), 2017.
Available on: http://repositorio.unifesp.br/handle/11600/50369
This manuscript involves theoretical elaboration and research reporting a qualitative-quantitative study, which aimed to investigate the emotional repercussions and quality of life of children and adolescents with chronic kidney disease. We studied 48 patients with chronic kidney disease: 24 patients who underwent hemodialysis and 24 patients who underwent renal transplantation. The 48 patient caregivers also participated in the study. The Pediatric Quality of Life Inventory – PedsQL TM 4.0 quality of life questionnaire and the Thematic Drawing-and-Story Procedure were used in the research. The analysis of the results found in the questionnaire of life quality was done through the sum of the points, with a score from 0 to 100. The Thematic Drawing-and-Story Procedure analysis consisted in collecting and extracting signifiers throughout the decomposition of the material present in the drawing and in the stories using the Freudian and Lacanian theories. In the statistical analysis of the data found in the quality of life questionnaire, the Mann-Whitney test for quantitative variables and the Chi-square test were used for comparisons between the groups, in order to compare proportions. Frequency tables were used to describe qualitative variables, while the quantitative variables were expressed as median (interquartile range). The average age at interview was 11.2 years (interquartile range of 8.2 to 14.7 years). Considering the quality of life questionnaire, the total score, which seeks to reflect the perception of the overall quality of life, was superior both in the transplant patients’ opinions and their caregivers. This finding suggests a better quality of life after renal transplantation. In the specific aspects, the physical capacity was also considered superior in the opinion of the transplant patients and their respective caregivers. There were no differences between groups of patients in the specific aspects: emotional, social and educational. However, this result opposed the transplanted patients’ caregivers opinion, since they noticed differences in the perception of the quality of life in the educational aspect. In the thematic story-books it was observed that the emotional suffering was evidenced in both groups studied. Therefore, no differences were found between renal replacement therapies regarding the psychological repercussions of chronic kidney disease. Renal transplantation may help the patient from a clinical and psychic point of view, but it should not necessarily be faced as a solution, since children and adolescents continue to be transgressed by subjectivity, their memories, pains, hospitalizations, consultations and also for keeping their lives with medications and medical care even after transplantation.