Mental health problems such as anxiety, depression, and ineffective family coping in children with lupus nephritis can increase the severity and affect the management of the disease, thus having an impact on the quality of life of children with lupus nephritis.
There are no studies that report the impact of anxiety, depression, family coping disorders on the quality of children with lupus nephritis. When in order to support the success of disease management, early detection is needed so the mental health problems are identified, and treatment can be done early according to the level of mental health disorders experienced. So we are interested and feel the need for research to identify the effects of levels of anxiety, depression, and family coping on children with lupus nephritis.
Mental Health and Quality of Life of Children with Lupus Nephritis
The advancement of medicine provides a longer life span for people with lupus nephritis, but there are still limitations to sufferers to carry out daily activities. It causes new problems for the sufferers, mental health problems such as anxiety, depression and problems with coping in the family, thus having an impact on the patient’s quality of life.
Mental health problems affect the management of lupus nephritis, which is a chronic disease, because it can increase the severity of the disease and reduce the quality of life of the children with lupus nephritis. Anxiety and depression disorders in children are increasing, and the prevalence of anxiety disorders and depression is higher in children with chronic diseases than in children without chronic diseases in the general population. Symptoms of lupus nephritis naturally have episodes of recurrence and remission phases which are also influenced by mental health disorders.
Family coping is needed in treating diseases in children, especially in children with chronic diseases such as lupus nephritis, because they have a tight schedule in administering treatment, both in the management of the induction phase to reduce the severity of the disease, for 6 months having to go back and forth monthly to the hospital for intravenous administration within 3-4 days every month. The drugs also have side effects on the child, so the child is in unpleasant situation, continued with the treatment phase to maintain a stable condition, to avoid increasing severity of the disease by providing a minimum possible long-term treatment. It is administered to an outpatient by conducting laboratory tests every month. So the family must support and do some adaptation (coping) to the child’s condition from various aspects.
The goal of management of chronic diseases, with various problems in the patient’s daily life is to improve the quality of life, so the patient can carry out daily activities independently as possible according to their abilities. Mental health disorders such as anxiety, depression, and lack of family coping will have an impact on the sufferer’s quality of life. So it is necessary to know as early as possible the level of mental health disorders to support the management of children with lupus nephritis.
Method and Results
This study found 62 children with lupus nephritis, 16 children in the induction phase and 46 children in the maintenance phase. Each child was measured to obtain the degree of severity of disease activity, anxiety, depression, family coping, and quality of life. The measurement results were compared between the induction phase and the maintenance phase.
The analysis showed that the levels of anxiety, depression, and disease severity were significantly higher in the induction phase group; whereas family coping and quality of life were higher in the maintenance phase group. Anxiety and depression in the induction and maintenance phase result in a decrease in the quality of life of the child. In family coping, the induction phase found reframing family coping subscales and family mobilization had an effect on quality of life, while in the maintenance phase of family coping subscales social support and family mobilization had an effect on quality of life.
The results of this research imply that children with lupus nephritis who require long-term therapy will face mental health problems. So it is necessary to evaluate mental health disorders to improve the quality of life of children with lupus nephritis. Mental health disorders reduce the quality of life of children with lupus nephritis where in the induction phase the quality of life is lower than the maintenance phase, so it is necessary to analyze the level of mental health disorders to maximize treatment management for children with lupus nephritis.
Author: Azwin Mengindra Putera, dr., Sp.A (K)
Details of the research available at:
Azwin Mengindra Putera, Irwanto Irwanto, Margarita Maria Maramis, Risky Vitria Prasetyo, Ninik Asmaningsih Soemyarso, Muhammad Sjaifullah Noer (2020). Effect of Mental Health on the Quality of Life in Children with Lupus Nephritis: Neuropsychiatric Disease and Treatment, 16: 1583-1593.
