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A number of factors affecting adherence have been reported in adults, but research is lacking in understanding the factors that contribute to adherence in children and adolescents with CKD. For this reason, it is difficult to explain what factors account for these comparable adherence rates. Our findings of high adherence across both literacy groups is a favorable outcome, which could suggest that this clinic sample is highly motivated to follow prescribed treatment and the clinic staff is effective at communicating the importance of following treatment recommendations selleck chemicals to caregivers of different literacy levels. We did find significant group differences in ER visits. Children of caregivers with low functional literacy reported significantly more ER visits. We expected to find that children's self-management was compromised as well, but this was not the case in our sample. Expectedly, condition/treatment modality (peritoneal dialysis, transplantation or CKD) was associated with the number of hospitalizations (peritoneal dialysis predicted more hospitalizations, P Azastene with higher pediatric ER use and more nonurgent visits [21]. Parents with low literacy seek ER care more often and for situations that do not warrant ��urgent�� care. It is possible that the symptoms and alterations in health are comparable, but less literate parents are more likely to interpret these situations as ��urgent��, and in need of immediate medical attention. In turn, when it comes to hospitalizations, the admission decisions are made by the provider, so parents consult with medical professionals to decide whether hospitalization is necessary; this website conversely, ER admissions are more easily parent driven in pediatric patient samples. Condition-specific literacy skills, particularly CKD or ESKD knowledge/understanding and perceived symptom severity, could also represent an important point of discrepancy between caregivers with low versus high literacy. Caregiver literacy predicted asthma-related knowledge, with less literate parents reporting a greater use of rescue medications for their children [14]. Another study, which examined risks and protective factors that contribute to hospital admissions and ER visits among children with complex chronic conditions [22], found that parents' lack of control, frequent worry and uncertainty in caring for the child were major risk factors, while caregivers' knowledge, experience and education were protective factors for these health services. Knowledgeable caregivers react quickly with adequate preventive treatments, promoting better outcomes.
