Relationships Between Perception of Illness, Social Support and Hemodialysis Adequacy

Abstract

Introduction. The patients in situations of "being ill" have to face not only pain and disabilities, but also problems in their social relationships. Perceptions of illness are results of reactions to the changes in the existential situations, and that these correspond to determined illness coping strategies.Aim. The aim of the research was to determine the relationships between perception of illness and social support, with the indicators of the adequacy of the renal replacement treatment and the level of urea as a biomarker of disease offset.Material and methods. The study was conducted on a group of 150 patients who were on chronic hemodialysis, and who were suffering from end stage renal disease. The patients were treated at on of the several Fresenius Medical centres. As a group, average Kt/V value was 1.45 (SD=0.22) and the URR ratio 71.78 (SD=5.95). Moreover, average urea concentration before HD equaled to 133.78mg% (SD=39.68) and after hemodialysis -38.22mg% (SD=14.60). The research procedure was based on a questionnaire study. This applied three standardized scales: the Imagination and Perception of Illness Scale (IPIS), the brief Illness Perception Questionnaire (IPQ-Brief) and the Berlin Social Support Scale (BSSS).Results. Patients who exhibited higher values of urea concentration in the blood serum measured before HD, perceived their disease (IPIS scale) as causing more motivation loss to carrying out specific activities, as well as mental and physical sphere destruction, pessimism and lost control over the disease. What is more, higher values of urea reduction ratio (URR) positively correlate with the loss of control over the disease (r=-0.20, p=0.024). Moreover, patients characterized by higher values of urea concentration in the blood serum before hemodialysis, evinced greater need for social support (BSSS).Conclusions. The need for social support among ESRD patients treated by hemodialysis does not correlate with dialysis adequacy indicators. Furthermore, the level of urea marked before hemodialysis exhibits an interdependence with psychological determinants of illness perception and social support.

The Relationship Between Psychological Resilience and Social Support Levels in Hemodialysis Patients

“…This is an expected result. Researches have shown that social support affects mental health in a positive and direct way, reduces stress with its buffering characteristic and has a positive effect on mental health (17,30,31). Inadequate social support is effective in increasing psychosocial problems in dialysis patients.…”

Perception of Own Illness and Trust in Medical Personnel among Chronically Ill People

“…Respondents put their answers on a seven-step scale, where "0" means the choice of the maximally positive item attributed to the disease and the number "6" signifies the opposite. The higher score obtained within a given IPIS dimension, the more negative the perception on the disease through the prism of this factor (Sak, 2014). The reliability of the above Scale was determined by α-Cronbach's coefficient, which exceeded the value of 0.7.…”

“…The first group includes life situation of the patient and the surrounding social support, while the determinants of an individual conditions are beliefs about own disease and its meaning (Nunstedt et al, 2017). Understanding and acceptance of the illness is of great importance in the therapeutic process, recovery and general well-being of the patient, however, depending on the diagnosis and the specificity of the disease, its perception varies (Sak et al, 2014).…”

Illness Perception of Turkish Patients Undergoing Hemodialysis and Peritoneal Dialysis: Similarities and Differences

“…Emotional responses shown towards the disease vary from individual to individual. Responses may show differences based on the meaning of affected organ or lossof-function for the individual, type of disease, age of the individual, developmental period, nature of personality, beliefs and attitudes, defense mechanisms and coping patterns, their previous experiences and attitudes of their relatives regarding the disease (6). The course of disease was found to be better in individuals who had a high perception of internal control (5).…”