Abstract
Long-surviving dialysis patients have increased in number thanks to improved dialysis treatment methods. On the other hand the grim reality remains that dialysis itself presents therapeutical problems that remain unsolved. One such problem is the psychological state of those patients who have been obliged to observe dietary restrictions in addition to the constraints placed on their free time and everyday modility. These daily life constraints usually induce psychological stress on the patients who eventually become unfit for dialysis treatment, and various researchers have reported on this problem. In the present study 12 dialysis patients were comparatively investigated with regard to psychological aspects after they had been receiving dialysis for total periods of 5 and 10 years.
Method: Social Adjustment Scale and Dialysis Sentence Completion Test devised at our university hospital were employed mainly for the following investigations. Dialysis patients undergoing dialysis for more than 10 years were studied with regard to such conditions and matters as adaptability to overall daily life before initiation of dialysis, attitude toward dialysis treatment and the future, rapport between the patients and medical staff, adaptability to the situation at home and the work place and general understanding of renal disease.
Discussion and Results: It was confirmed that those patients who were best able to tolerate the long-lasting agonizing dialysis treatment had generally been in a better adaptive state during their daily lives before initiation of dialysis and that rapport between then and medical staff had been favorably maintained from that time onwards. Such favorable rapport has previously been thought of as one of the principal factors for the well-being of patients undergoing long-term dialysis treatment. Moreover, it was suggested that if patients were able to face up to the “fear of the disease” for themselves, this was instrumental in helping them establish a “treatmentfirst” concept.
Anxiety about future life and fear of death are also crucial problems for such patients, the solution to which, in our opinion, rests with how much of a useful life they lead, and therefore the degree to which they deal with real-life situations.
