Denial in Dialysis Patients: Relationship to Compliance and Other Variables

Yanagida, Evelyn H.; Streltzer, Jon; Siemsen, Arnold W.

doi:10.1097/00006842-198106000-00008

Cited by 37 publications

(14 citation statements)

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“…The latter refers to the observation that some patients cannot tolerate open dependency on other individuals or on the HD machine and may behave in a manner inju rious to their own health as a result. It is unclear whether denial is related to noncompliance [32,33].…”

Section: Determinants For Compliance In Esrd Patientsfactors Related mentioning

confidence: 99%

Treatment Compliance in End-Stage Renal Disease Patients on Dialysis

et al. 1986

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This paper reviews the current knowledge concerning treatment compliance in patients with end-stage renal disease (ESRD). Adult hemodialysis patient noncompliance with the treatment regimen is very common. Objective and subjective measures of compliance, however, are often weakly correlated. In addition, the patients may be compliant with some aspects of the treatment regimen, but noncompliant with others. Unfortunately, no current model of predicting the degree of hemodialysis patient compliance is very accurate. In spite of this, behavioral approaches to increase regimen compliance do have at least short-term efficacy. There is a paucity of published data on compliance in adult peritoneal dialysis patients and an almost complete absence of systematic studies of compliance in children and adolescent dialysis patients. A multidimensional nosology of compliance behavior in ESRD patients is, therefore, proposed, as well as an approach to the diagnosis of noncompliance in ESRD patients and to possible interventions.

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Section: Determinants For Compliance In Esrd Patientsfactors Related mentioning

confidence: 99%

Treatment Compliance in End-Stage Renal Disease Patients on Dialysis

et al. 1986

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“…For this purpose, it is more helpful to investi gate beliefs and attitudes patients may hold which might be associated with poor adherence. Such cognitive factors investigated to date include locus of control [7][8][9][10][11][12][13][14], health beliefs [8. 15.…”

Section: Introductionmentioning

confidence: 99%

“…15. 16], causal attributions [13], and more spe cific cognitive variables such as resourcefulness [17] or denial [7],…”

Section: Introductionmentioning

confidence: 99%

Psychosocial and Cognitive Factors Associated with Adherence to Dietary and Fluid Restriction Regimens by People on Chronic Haemodialysis

Sensky

Léger

Gilmour³

1996

Psychother Psychosom

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Background: Failure by people on chronic haemodialysis to adhere adequately to dietary and fluid restrictions can have serious medical consequences. Numerous psychosocial factors possibly associated with adherence have been investigated in previous research. However, most previous studies have examined one or a few variables in isolation, and have tended to focus on sociodemographic variables not easily amenable to intervention. Much previous work has tended to ignore potential differences in adherence between male and female dialysands. Methods: Sociodemographic and psychosocial factors associated with adherence to dietary and fluid restrictions were investigated in 45 people on haemodialysis attending one renal unit, excluding those with a residual urine volume > 500 ml/day. Multiple regression analyses were used to estimate the contribution to adherence of a range of variables, including gender, age, duration of dialysis, affective disturbance, past psychiatric history, health locus of control, social adjustment and social supports. Results: Adherence to diet (measured by predialysis serum potassium) and to fluid restriction (interdialysis weight gain) were not linked, and had different psychosocial correlates. Regression models of four different aspects of adherence revealed very distinct psychosocial correlates, with contributions to adherence from complex interactions between psychosocial and cognitive variables, notably gender, age, social adjustment, health locus of control, and depression. Conclusions: The findings cast doubt on the results of many previous studies which have used simple models of adherence. Adherence is likely to be influenced in a complex manner by multiple factors including age, gender, locus of control, social adjustment, and past psychiatric history.

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“…Under a severely stressful condition, such as dialysis therapy [16] and organ transplantation [17], 'denial' is an effective psychological mechanism for coping to prevent depression and allow satisfactory adaptation to maintenance dialysis treatment. Alexithymia is charac terized by difficulty in expressing one's feelings verbally and a lack of fantasy [7][8][9][10][11][12], Many studies have shown that alexithymia results from a variety of psychological sources which are associated with defense mechanisms such as 'denial' [8,9,19].…”

Section: Discussionmentioning

confidence: 99%

Psychological Problems of Kidney Transplantation: Satisfaction with Dialysis Therapy and Desire for Transplantation in Hemodialysis Patients

Fukunishi

1993

Nephron

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Psychological problems of kidney transplantation were examined in 275 hemodialysis patients. Desire for transplantation was significantly lower in aged patients than in nonaged cases. The prevalence of alexithymia which is characterized by difficulty in expressing one’s feelings and a lack of fantasy and which may be a clinical feature associated with psychological defense mechanisms was significantly higher in aged than in nonaged patients. The results suggest that aged patients tend to suppress the desire for transplantation by means of psychological defense mechanisms such as ‘denial’ directed toward transplantation and an unconscious pretence of indifference. From the psychological aspect, reconsideration of the quality of life may be required for hemodialysis patients.

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Denial in Dialysis Patients: Relationship to Compliance and Other Variables

Cited by 37 publications

References 0 publications

Treatment Compliance in End-Stage Renal Disease Patients on Dialysis

Treatment Compliance in End-Stage Renal Disease Patients on Dialysis

Psychosocial and Cognitive Factors Associated with Adherence to Dietary and Fluid Restriction Regimens by People on Chronic Haemodialysis

Psychological Problems of Kidney Transplantation: Satisfaction with Dialysis Therapy and Desire for Transplantation in Hemodialysis Patients

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