ATTITUDE TO ILLNESS OF CHRONIC HEMODIALYSIS PATIENTS
https://doi.org/10.24884/1561-6274-2005-9-2-53-60
Abstract
THE AIM of the investigation was to determine the types of attitude to illness prevailing in patients on hemodialysis (HD) and the variables associated with the attitude of these patients to illness. PATIENTS AND METHODS. Examination of 218 patients treated by chronic HD allowed to detect their subjective attitude to the illness and to study the treatment with the questionnaire «Type of attitude to illness». The following parameters were determined in all the patients: quality of life, coping strategies, levels of depression, asthenia and anxiety as well as the clinical signs in order to establish the variables associated with the attitude of these patients to their illness. RESULTS. The HD patients mostly had ergopathic («getting away from disease to work»), sensitive (with hypersensitivity) and harmonious types of attitude to illness. In 62% of the patients types of the attitude of the adaptive block prevail that speaks of adaptive reaction to the illness and treatment. The types of attitude to illness was shown to be connected with the parameters of life quality, character of emotional sphere, labor employment, level of education, strategies of overcoming the problems, duration of the kidney disease and HD treatment, specificity of beginning HD, blood serum albumin level, change of the body mass for the last 6 months. CONCLUSION. HD patients mainly have the ergopathic, sensitive and harmonious types of attitude to the illness, the paranoiac and dystrophic types are rare that speaks of good adaptive potency of these patients. The attitude to illness is closely connected with the quality of life of the patient, the emotional state, employment, education level, coping strategies and following medical recommendations.
About the Author
I. A. Vasilieva
Научно-исследовательский институт нефрологии, Санкт-Петербургский государственный медицинский университет им. акад. И.П. Павлова
Russian Federation
Russian Federation
References
1. Лурия РА. Внутренняя картина болезней и иатрогенные заболевания. М., 1977:
2. Николаева ВВ. Влияние хронической болезни на психику. Издательство МГУ, М., 1987: 168
3. Ковалев ВВ. Личность и ее нарушения при соматической болезни. В: Роль психических факторов в происхождении, течении и лечении соматических болезней. М.; 1972: 102115
4. Рохлин ЛЛ. «Сознание болезни» и его значение в клинической практике. Клиническая медицина 1957; 35 (9): 11 20
5. Вассерман ЛИ, Иовлев БВ, Карпова ЭБ и др. Усовершенствованный вариант опросника для психологической диагностики типов отношения к болезни. Методические рекомендации. Психоневрологический институт им. В. М. Бехтерева, СПб., 2001: 33
6. Bremer BA, Haffly D, Foxx RM, Weaver A. Patients’ perceived control over their health care: an outcome assessment of their psychological adjustment to renal failure. Amer J Med Qual 1995; 10 (3): 149154
7. Kutner NG, Zhang R, McClellan WM et al. Psychosocial predictors of noncompliance in haemodialysis and peritoneal dialysis patients. Nephrol Dial Transplant 2002; 17: 9399
8. Kimmel PL. Psychosocial factors in adult endstage renal disease patients treated with hemodialysis: correlates and outcomes. Am J Kidney Dis 2000; 35 [Suppl 1]: S132S140
9. Kimmel PL, Peterson RA, Weihs KL et al. Psychosocial factors, behavioral compliance and survival in urban hemodialysis patients. Kidney Int 1998; 54 (1): 245254
10. Cvengros JA, Christensen AJ, Lawton WJ. The role of perceived control and preference for control in adherence to a chronic medical regimen. Ann Behav Med 2004; 27 (3): 155161
11. Prendergast TJ, Luce JM. Increasing incidence of withholding and withdrawal of life support from the critically ill. Am J Respir Crit Care Med 1997; 155: 1520
12. Fried TR, Bradley EH, Towle VR et al. Understanding the treatment preferences of seriously ill patients. N Engl J Med 2002; 346: 10871089
13. Kliger AS, Finkelstein FO. Which patients choose to stop dialysis? Nephrol Dial Transplant 2003; 18: 869871
14. Jassal S, Borganza C, Naglie G. Can older patients do better on dialysis? Identifying a motivation problem. Nephrol Dial Transplant 2002; 17, Abstracts, [Suppl1 P]:295
15. Муладжанова ТН. Психологический анализ изменений личности у больных хронической почечной недостаточностью, находящихся на лечении гемодиализом. Автореф дисс канд психол наук. М., 1983: 14
16. Васильева ИА. Нарушения в системе личностных отношений у больных, находящихся на лечении хроничес ким гемодиализом. В: Психические расстройства в соматической клинике. Л.; 1991: 4551
17. Васильева ИА. Психическая адаптация больных с хронической почечной недостаточностью к лечению гемо диализом. Автореф дисс канд психол наук. СПб., 1992: 20
18. Zung WWK. A selfrating depression scale. Arch Gen Psychiat 1965; 12: 6370
19. Spielberger CD et al. Manual for the State-Trait Anxiety Inventory (STAI). Palo Alto, CA. Consulting Psychologists Press, 1983
20. Вассерман ЛИ, Вукс АЯ, Иовлев БВ и др. Шкала для психологической диагностики уровня невротической астении. Методические рекомендации. Психоневрологический институт им. В. М. Бехтерева, СПб., 1998: 18
21. Ware JE, Snow KK, Kosinski M et al. SF-36 Health Survey. Manual and Interpretation Guide. MA. Health Institute, Boston, 1993: 22
22. Folkman S, Lazarus RS. Manual for the Ways of Coping Questionnaire. Palo Alto, CA. Consulting Psychologists Press, 1988
23. Васильева ИА, Исаева ЕР, Румянцев АШ, Ткалина ЕВ, Щелкова ОЮ. Копингстратегии больных, находящихся на лечении хроническим гемодиализом. Нефрология 2004; 8(4): 4551
24. Васильева ИА, Добронравов ВА, Бабарыкина ЕВ. Факторы, влияющие на трудовую занятость больных, находящихся на лечении хроническим гемодиализом. Нефрология 2004; 8(1): 5661
Review
For citations:
Vasilieva I.A. ATTITUDE TO ILLNESS OF CHRONIC HEMODIALYSIS PATIENTS. Nephrology (Saint-Petersburg). 2005;9(2):53-60. (In Russ.) https://doi.org/10.24884/1561-6274-2005-9-2-53-60
Views:
420
Email this article 