Psychosocial Burden of Renal Replacement Therapy in Children and Young People – How to Cope with Chronic Disease

Chronic Disease and the ensuing life-sustaining therapies such as renal replacement therapy imply prolongation of life time and significant improvement of quality of life. However, due to dramatic changes in the individual development of the child and within the family systems and due to extremely threatening experiences, this process involves psychical and psycho-social stress which might cause major psychical disorders in case of unappropriate coping. In the first part of this paper the psycho-social and psychical impact of renal replacement therapy will be discussed on the basis of case reports, in the second part the process of coping in patients with chronic disease will be demonstrated and finally, the third part aims at explaining the integrative concept of psycho-social care.