The role of nursing care in early adjustment to regular hemodialysis. A clinical analysis using psychological testing.
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In patients beginning regular hemodialysis (HD), psychological receptivity to HD may be an important factor in adjustment. In the present work, we studied how to support a smooth transition to regular HD and to improve the quality of life afterwards. Eighteen patients admitted to the hospital since 1987 were selected. The following psychological tests were administered when patients were introduced to regular HD and just before dischage to assess their psychological condition: The Social Adjustment Scale (SAS), Sentence Completion Test for HD Patients (D-SCT) and Manifest Anxiety Scale (MAS). With these results, changes in anxiety and in adjustment to HD from admission to discharge were evaluated. Adaptability to HD, self-control and human relations with their families were also studied.According to the results just before discharge, patients were classified as follows. Group I (5 patients) included those who "adjusted" with a high degree of anxiety. Group II (6 patients), those who "adjusted" with a low degree of anxiety, were further divided into two subgroups: II-a, who remained in group II after admission, and II-b, who changed to group II after admission. Group III (7 patients) showed "escape" and a low degree of anxiety. Fink's theoretical model of crisis showed typical psychological steps of adjustment to HD such as from group III to II-b, from II-b to I and I to II-a, regarded as complete adjustment.In conclusion, well-adjusted patients showed adaptability, good family relations and self-control. The important point in nursing may be "neutrality" and helping the patient adjust to and accept regular HD. This might help the patient to be more independent and reduce anxiety about HD.
- 社団法人 日本透析医学会の論文
社団法人 日本透析医学会 | 論文
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