Relationships Between Perception of Illness, Social Support and Hemodialysis Adequacy
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.
- Department of Ethics and Human Philosophy, Medical University of Lublin, Poland, email@example.com
- Chair and Department of Nephrology, Medical University of Lublin, Lublin, Poland
- Fresenius Nephrocare Polska Sp. z o.o. Poznań, Poland
- Department of Ethics and Human Philosophy, Medical University of Lublin, Poland
- 1. Cukor D, Cohen SD, Peterson RA, Kimmel PL. Psychosocial aspects of chronic disease: ESRD as a paradigmatic illness. J Am Soc Nephrol. 2007;18(12):3042-55.[WoS][PubMed][Crossref]
- 2. Fowler C, Baas LS. Illness representations in patients with chronic kidney disease on maintenance hemodialysis. Nephrol Nurs J. 2006;33(2):173-4, 179-86.[PubMed]
- 3. Chilcot J, Wellsted D, Farrington K. Illness representations are associated with fluid non-adherence among hemodialysis patients. J Psychosom Res. 2010;68(2):203-12.[Crossref][WoS]
- 4. Kim Y, Evangelista LS. Relationship between illness perceptions, treatment adherence, and clinical outcomes in patients on maintenance hemodialysis. Nephrol Nurs J. 2010;37(3):271-80.[PubMed]
- 5. Chilcot J, Norton S, Wellsted D, Farrington K. The factor structure of the Revised Illness Perception Questionnaire (IPQ-R) in end-stage renal disease patients. Psychol Health Med. 2012;17(5):578-88.[WoS][PubMed][Crossref]
- 6. Tasmoc A1, Hogas S, Covic A. A longitudinal study on illness perceptions in hemodialysis patients: changes over time. Arch Med Sci. 2013;9(5):831-6.[WoS][Crossref][PubMed]
- 7. van Dijk S, Scharloo M, Kaptein AA, et al. NECOSAD Study Group. Patients' representations of their end-stage renal disease: relation with mortality. Nephrol Dial Transplant. 2009;24:3183-5.
- 8. Chilcot J, Wellsted D, Farrington K. Illness perceptions predict survival in haemodialysis patients. Am J Nephrol. 2011;33:358-63.[PubMed][Crossref]
- 9. Drążkowski D, Cierpiałkowska L. Zależność/niezależność od pola a wsparcie społeczne w kontekście stresu. Psychol Qual Life. 2013;12(1):29-41.
- 10. Khalil AA, Abed MA. Perceived social support is a partial mediator of the relationship between depressive symptoms and quality of life in patients receiving hemodialysis. Arch Psychiatr Nurs. 2014;28(2):114-8.[PubMed][Crossref][WoS]
- 11. Plantinga LC, Fink NE, Harrington-Levey R, et al. Association of social support with outcomes in incident dialysis patients. Clin J Am Soc Nephrol. 2010;5(8):1480-8.[Crossref][PubMed]
- 12. Untas A, Thumma J, Rascle N, et al. The associations of social support and other psychosocial factors with mortality and quality of life in the dialysis outcomes and practice patterns study. Clin J Am Soc Nephrol. 2011;6(1):142-52.[Crossref][PubMed]
- 13. Daugirdas JT. Second generation logarithmic estimates of singlepool variable volume Kt/V: an analysis of error. J Am Soc Nephrol. 1993;4(5):1205-13.[PubMed]
- 14. Sak J. Wielowymiarowość postrzegania choroby w kontekście przekonań zdrowotnych i poczucia sensu życia: rozprawa habilitacyjna. Lublin: Jarosław Sak; 2013.
- 15. Broadbent E, Petrie KJ, Main J, Weinman J. The Brief Illness Perception Questionnaire. J Psychosom Res. 2006;60:631-7.[PubMed][Crossref]
- 16. Leventhal H, Benyamini Y, Brownlee S, et al. Illness representations: Theoretical Foundations. In: K. J. Petrie, J. Weinman (eds). Perceptions of health and illness: Current research and applications. Amsterdam: Harwood Academic Publishers; 1997. p.19-45.
- 17. Łuszczyńska A, Kowalska M, Schwarzer R, Schulz U. Berlin Social Support Scales (BSSS) - Polish Version, 2002. [http://userpage.fu-berlin. de/~health/soc_pol.htm]
- 18. Sułowicz W. Praktyczne aspekty oceny jakości dializoterapii Forum Nefrolog. 2010;3(3):185-192.