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      Reviewing and comparing self-concept in patients undergoing hemodialysis and peritoneal dialysis

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          Abstract

          Background:

          Chronic renal disease is a health problem in today’s world. In the end-stages of renal disease patients depend upon alternative therapies including dialysis for their survival. However, dialysis causes several stressors on physical, mental and social performance of patients. The present study aimed to review and compare the self-concept in patients undergoing hemodialysis and peritoneal dialysis.

          Materials and Methods:

          This was a case-control study including two groups of patients, undergoing hemodialysis and peritoneal dialysis, who referred to Al-Zahra and Ali Asghar Hospitals, which are affiliated to Isfahan University of Medical Sciences. These groups were compared to the control group. Data were collected through completing the form of demographic characteristics and a questionnaire, written by the researcher, pertaining to the self-concept which was collected by the samples. The data were analyzed by the Software SPSS version 18.

          Findings:

          ANOVA (analysis of variance) showed that statistically there was a significant difference between mean score of self-concept in the three physical (body-image), psychological, and social self aspects in the two groups of hemodialysis and peritoneal dialysis with the control group; however, Duncan’s post-hoc analysis showed no significant difference between mean score of self-concept in the three mentioned aspects in the two groups of hemodialysis and peritoneal dialysis. Furthermore, ANOVA (analysis of variance) showed that there was no significant difference between mean score of the spiritual aspect of the self-concept in the two groups of hemodialysis and peritoneal dialysis with the control group. Duncan’s post-hoc analysis also showed no significant difference in this aspect between the two groups of hemodialysis and peritoneal dialysis.

          Conclusions:

          Patients undergoing dialysis have many psychological disorders and the type of dialysis is not of much importance in this regard; therefore, adequate education and information for clients in order to use appropriate methods of adaptation as well as appropriate social relationship, continuing social support and developing health policies seem necessary in order to prevent mental disorders and providing required services and supports for patients.

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          Most cited references57

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          Hemodialysis and peritoneal dialysis: patients' assessment of their satisfaction with therapy and the impact of the therapy on their lives.

          This study was undertaken to examine patient satisfaction with peritoneal dialysis (PD) and hemodialysis (HD) therapies, focusing attention on the positive and negative impact of the therapies on patients' lives. Patients were recruited from a free-standing PD unit and two free-standing HD units. A total of 94% (n = 62) of eligible PD and 84% (n = 84) of eligible HD patients participated. HD patients were significantly older and had higher Charlson Comorbidity Index scores than the PD patients, but there were no differences in duration of dialysis treatment, prevalence of diabetes, educational backgrounds, or home situations. Patients were asked to rate their overall satisfaction with and the overall impact of their dialysis therapy on their lives, using a 1 to 10 Likert scale. In addition, patients were asked to rate the impact of their therapy on 15 domains that had been cited previously as being important for patients' quality of life. The mean satisfaction score for PD patients (8.02 +/- 1.41) was higher than for HD patients (7.4 +/- 1.4; P = 0.15). PD patients indicated that there was less impact of the dialysis treatment on their lives globally (7.25 +/- 2.12 versus 6.19 +/- 2.83; P = 0.019). In addition, PD patients noted less impact of the therapy in 14 of the 15 domains examined. With the use of a proportional odds model analysis, the only significant predictor of overall satisfaction and impact of therapy was dialysis modality (P = 0.037 and P = 0.021, respectively). Patients also were asked to comment freely on the positive and negative effects of the dialysis treatments on their lives, and a taxonomy of patient perceptions and concerns was developed. This study suggests that PD patients in general are more satisfied with their overall care and believe that their treatment has less impact on their lives than HD patients.
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            The experiences of loneliness, depression, and social support of Turkish patients with continuous ambulatory peritoneal dialysis and their caregivers.

            The aim of the study was to examine the relationship between loneliness, depression and social support of Turkish patients with continuous ambulatory peritoneal dialysis and their caregivers. By altering the lifestyle of the patient and family or caregiver, chronic illness and continuous ambulatory peritoneal dialysis can create loneliness and depression. Perceived social support may facilitate coping with illness. Descriptive correlational design was used. Data were collected by using the UCLA loneliness scale, the Beck's depression scale and the perceived social support from family and friends scales and demographic data form. A total of 130 subjects including 65 patients with continuous ambulatory peritoneal dialysis and 65 caregivers took part in this study. The mean ages of the patients and caregivers were similar (44.69 +/- 17.22 and 43.90 +/- 8.52 years respectively). Scores of loneliness and depression were below cut-off scores in both groups. However, scores of the loneliness of patients were higher than that of the caregivers. Perceived social support from family and friend were above cut-off scores in both groups and it was different for patients and caregivers. The results of this study indicate that Turkish patients with continuous ambulatory peritoneal dialysis and their caregivers did not experience loneliness and depression. Results of the study suggest that the nurses need to be aware of patients' and caregivers' psychological reactions to continuous ambulatory peritoneal dialysis, which may be expressed in feelings of loneliness and depression, and employ social support resources for patients with peritoneal dialysis and caregivers to cope with their illness and to adapt lifestyle changes.
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              Body-image disturbance in adult dialysis patients.

              An increasing number of individuals in the UK develop end-stage renal failure and receive dialysis to prolong their lives. Dialysis-users report elevated levels of psychological morbidity which are associated with poorer quality of life, adjustment to illness and increased mortality. Circumscribed evidence has also identified body-image (BI) changes occurring in dialysis-users which are already known to be associated with psychological morbidity in other chronically ill populations. This study aimed to identify the prevalence of body-image disturbance (BID) in a dialysis population, correlation with psychological distress, and to identify any variables associated with increased BID and psychological morbidity. Particular attention was given to cognitive models of emotion which postulate a key role for self-consciousness and appearance-related beliefs. Between May and August 2007, 97 adult haemodialysis and peritoneal dialysis patients from a UK regional specialist centre responded to a questionnaire survey. Outcome measures comprised the Body Image Disturbance Questionnaire, Hospital Anxiety and Depression Scale, Self-consciousness Scale and the Appearance Schemas Inventory-Revised. Prevalence of anxiety and depression was 24.7% and 18.6%, respectively, with levels of BID significantly above community norms for both male and female respondents. Significant associations were found between psychological morbidity and BID and with specific aspects of appearance-schematisation and self-focus. Patients should be educated regarding the likely physical consequences of dialysis-types to aid decision-making and prepare them for impacts once dialysis is commenced. Clinicians may wish to monitor dialysis-users for distress and BI difficulties at follow-up appointments. Interventions that target appearance-related beliefs and BID may be of benefit to this population.
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                Author and article information

                Journal
                Iran J Nurs Midwifery Res
                Iran J Nurs Midwifery Res
                IJNMR
                Iranian Journal of Nursing and Midwifery Research
                Medknow Publications & Media Pvt Ltd (India )
                1735-9066
                2228-5504
                February 2012
                : 17
                : 2 Suppl1
                : S85-S90
                Affiliations
                [1 ]Department of Critical Care Nursing, Kidney Disease Research Center, School of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran
                [2 ]MSc Student, Student Research Committee, Department of Surgical-Nursing Education, School of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran
                [3 ]Department of Psychiatric Nursing, School of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran
                Author notes
                Address for correspondence: Setareh Tajdari, MSc Student, Student Research Committee, Department of Surgical-Nursing Education, School of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran. E-mail: setarehtajdari@ 123456yahoo.com
                Article
                IJNMR-17-85
                3696965
                23833607
                2a54f3ec-7b0f-4229-a1ae-e548a1a08839
                Copyright: © Iranian Journal of Nursing and Midwifery Research

                This is an open-access article distributed under the terms of the Creative Commons Attribution-Noncommercial-Share Alike 3.0 Unported, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                Categories
                Original Article

                Nursing
                peritoneal dialysis,self-concept,hemodialysis
                Nursing
                peritoneal dialysis, self-concept, hemodialysis

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