Problems in Adaptation to Maintenance Hemodialysis

The Problem of Fatigue in Dialysis Patients

“…Fatigue is also often an accompaniment of depression, and depression has been widely ascribed to dialysis patients [2,3,9]. A comparison of depression scores and fatigue rating showed that those reporting high fatigue in the morning tended to have the highest depression scores even when questions related to fatigue were deleted from the psychological test.…”

The Psychological Aspects of Chronic Hemodialysis*

“…Authors reported repeatedly (I, 8,11,16,18,24,28,32,34) that the major adaptational problem in hemodialysis lies in the area of emotional dependency. Dependence on the dialysis machine for survival is a reality, and it has been suggested that psychological dependency needs expand to the point where staff are unable to gratify them.…”

“…Abram (3), writing on suicidal behaviour in chronic dialysis patients, suggested that the high incidence of suicide is related to the emotional consequences -the difficulty in accepting dependency generated by passivity and inactivity. Depression has been noted by many authors (1,2,8,10,11,17,18,24,28,(32)(33)(34) to be a major problem. Reichman and Levy (28) found that all their twenty-five patients were significantly depressed before acceptance into the dialysis program.…”

“…Depression has been noted by many authors (1,2,8,10,11,17,18,24,28,(32)(33)(34) to be a major problem. Reichman and Levy (28) found that all their twenty-five patients were significantly depressed before acceptance into the dialysis program. Most authors related depression to stresses induced by the mechanical difficulties and to the stresses of living with dialysis as a requisite for life maintenance.…”

“…removal of this denial would make the patient on the one hand comply more but on the other hand become less adjusted to the other aspects of his life on dialysis." Reichman and Levy (28) felt that denial often seemed to serve a useful adaptive function. During some periods of depression it apparently protected patients from experiencing more intense helplessness, and during some periods of contentment it preserved their sense of well-being.…”