Psychological Distress and Quality of Life in CKD Caregivers: Exploring Neurobehavioral Correlates Across Disease Stages.

Abstract

Background: Caregivers of children with chronic kidney disease (CKD) often face significant psychological and social challenges. This study aimed to assess the extent of psychological distress, quality of life (QOL), coping strategies and associated risk factors among caregivers and to evaluate whether these issues intensify with advanced stages of CKD.

Methods: A cross-sectional observational study was conducted at a tertiary care centre in North India, enrolling 50 consecutive caregivers of children with CKD between July 2020 and June 2021. Participants were categorised into two groups: Early-stage CKD (Stages 1-2) and advanced-stage CKD (Stages 3-5). Caregivers were assessed using the Paediatric Renal Caregiver Burden Scale (PRCBS), Depression Anxiety Stress Scale (DASS-21), World Health Organisation Quality of Life Scale-Brief (WHOQOL-BREF) and Ways of Coping Checklist. Relevant statistical analyses were performed.

Results: Caregivers of children with advanced CKD reported higher levels of psychological distress, with 88.5% experiencing moderate to severe depression, 38% anxiety and 35% stress. In contrast, caregivers of early-stage CKD children reported depression in 21%, with no cases of moderate to severe anxiety or stress. QOL scores were significantly lower and burden scores significantly higher, in the advanced CKD group. Lower socioeconomic status, reduced maternal education and low household income were linked to higher distress and poorer QOL. Problem-focused coping strategies were commonly used across both groups.

Conclusion: Psychosocial difficulties and caregiver burden increase with CKD severity and adversely affect QOL. Early identification and psychological support for caregivers may enhance overall outcomes for both the child and family.