Patient strategies for managing maintenance hemodialysis

Support and coping of male hemodialysis-dependent patients

The purpose of this descriptive-correlational study was to describe coping strategies used by males with chronic renal failure who are dependent on hemodialysis; to describe their social networks; to describe the perceived support, conflict, and reciprocity within their interpersonal relationships; and to examine the relationships among the variables support, conflict, reciprocity, social networks, and coping strategies. Social support was conceptualized as a coping resource or source of assistance in coping with the renal illness- or hemodialysis-related stressor. The Ways of Coping questionnaire and the Interpersonal Relationship Inventory were administered to 30 participants while in hospital. Although, both problem-focused and emotion-focused forms of coping were used, participants primarily used problem-focused coping, in particular, "seeking social support". Overall, the participants perceived relatively high levels of support and moderate to high levels of reciprocity with members of their social networks. Participants experienced a moderate level of conflict in their interpersonal relationships. Both escape-avoidance and conflict were positively associated with the number of people in the household. Positive reappraisal was negatively associated with the number of close relatives. The small sample size prohibits generalizability of the results. Longitudinal studies with a larger randomly selected sample would yield insights into the long-term psychological outcomes of different coping strategies and into the bi-directional relationship of support from social network and coping in this population. Implications for nurses are discussed.

Quality of life in predialytic uremic patients

This study describes and analyses how 38 predialytic uremic patients perceived their sense of well-being, functional ability, level of anxiety and sense of coherence. The patients in this study reported decreased sense of well-being, considerable functional disabilities, and a high level of anxiety when compared to a healthy reference group. These observations were independent of laboratory data with the exception of hemoglobin concentration which showed a significant negative correlation to the SIP scale work. There was a significant negative correlation between the scores of sense of coherence and anxiety. Patients with a weak sense of coherence and a high level of anxiety perceived their well-being as being worse than those with higher scores in the sense of coherence test and lower scores in the level of anxiety test. Sense of well-being in turn influenced functional ability in daily life. Social and marital status also affected the results. These results indicate that the investigated group of predialytic patients have a decrease in quality of life. The results obtained provide a useful instrument showing in which areas care should be concentrated and in what way patients' own resources need to be strengthened while preparing for dialysis treatment.