Family environment, child behavior, and medical indicators in children with kidney disease.

Effects of family environment on child behavior symptoms and medical indicators in children with one of three kidney diseases were examined. Parents (n = 41) of children with nephrotic syndrome, chronic renal insufficiency, or kidney transplant completed family environment and child behavior questionnaires. Medical indicators (utilization and medications) were collected from medical records. A model including child age, diagnostic group, and family environment variables successfully predicted all outcomes except internalizing behavior. Higher family conflict predicted more externalizing symptoms and higher number of prescribed medications; higher family cohesion predicted fewer hospitalizations. Nontraditional family structure predicted higher number of prescribed medications. Results are discussed as they relate to a stress and resistance framework, need for research on direction of effect, and clinical recommendations.