The manner in which dialysis patients respond to the stress of chronic renal failure has been focused on in an active body of research. The general approach to the concept of adjustment is critically reviewed and its implications for research considered. A number of important selected factors are reviewed and conclusions in each of the areas are presented. Specific problems are defined and alternative approaches proposed.
Get full access to this article
View all access options for this article.
References
1.
RobertsS. D.MaxwellD. R.GrossT. L., Cost-Effective Care of End-Stage Renal Disease: A Billion Dollar Question, Ann. Intern. Med., 92, pp. 243–248, 1980.
2.
WeissmanA. D., On Dying and Denying, Behavioral Publications, Inc., New York, 1972.
3.
Kaplan-De-NourA.CzaczkesJ., Bias in Assessment of Patients on Chronic Dialysis, J. Psychosom. Res., 18, pp. 217–221, 1974.
4.
Kaplan-De-NourA.CzaczkesJ., Personality Factors Influencing Vociational Rehabilitation, Arch. Gen. Psychiat., 32, pp. 573–577, 1975.
5.
LewisE.FosterM.De la PirenteJ.ScurlockC., Survival Data for Patients Undergoing Chronic Intermittent Hemodialysis, Ann. Intern. Med., 70, p. 311, 1969.
6.
MalmquistA., A Prospective Study of Patients in Chronic Hemodialysis I. Method and Characteristics of the Patient Group, J. Psychosom. Res., 17, pp. 333–337, 1973a.
7.
MalmquistA., A Prospective Study of Patients in Chronic-Hemodialysis II. Predicting Factors Regarding Rehabilitation, J. Psychosom. Res., 17, pp. 339–344, 1973b.
8.
GreenbergR.DavidG.MasseyR., The Psychological Evaluation for a Kidney Transplant and Hemodialysis Program, Amer. J. Psychiat., 130, pp. 274–277, 1973.
9.
WertzelH.VollrathD.RitzE.FernerH., Analysis of Patient-Nurse Interaction in Hemodialysis Units, J. Psychosom. Res., 21, pp. 359–366, 1977.
10.
ProcciW., Dietary Abuse in Maintenance Hemodialysis, Psychosom. Med., 1, pp. 16–24, 1978.
11.
ShortM.WilsonW., Roles of Denial in Chronic Hemodialysis, Arch. Gen. Psychiat., 20, pp. 433–437, 1969.
12.
Strauch-RahauserG.SchafheutleR.LipkeR.StrauchM., Measurement Problems in Long-Term Dialysis Patients, J. Psychosom. Res., 21, pp. 49–54, 1977.
13.
StrauchM.HuberW.RahauserG.WernerJ.WalzerP.HafnerH., Rehabilitation in Patients Undergoing Maintenance Hemodialysis: Results of a Questionnaire in 15 Dialysis Centres, Proc. Europ. Dial. and Trans. Assoc., 8, pp. 28–32, 1971.
14.
HuberW.Strauch-RahauserG.WernerJ.HofnerH.StrauchM., Factors Influencing Rehabilitation in Regular Hemodialysis – A Standardized Questionnaire in 222 Patients, Proc. Europ. Dial. and Trans. Assoc., 9, pp. 257–264, 1972.
15.
FosterF.CohenG.McKegneyF., Psychobiologic Factors and Individual Survival on Chronic Renal Hemodialysis, Psychosom. Med., 35, pp. 64–68, 1973.
16.
FosterF. G.McKegneyF. P., Small Group Dynamics and Survival on Chronic Hemodialysis, Int. J. Psychiat. in Med., 8, pp. 105–106, 1978.
17.
GoldsteinA.ReznikoffM., Suicide in Chronic Hemodialysis Patients from an External Locus of Control Framework, Amer. J. Psychiat., 127, pp. 1204–1207, 1971.
18.
GlassmanB.SiegelA., Personality Correlates of Survival in a Long-Term Hemodialysis Program, Amer. J. Psychiat., 122, p. 566, 1970.
19.
ArmstrongS. H., Psychological Maladjustment in Renal Dialysis Patients, Psychosom. Med., 19, pp. 169–171, 1978.
20.
CummingsJ., Hemodialysis – Feelings, Facts, Fantasies, Amer. J. Nurs., 70, pp. 70–79, 1970.
21.
DemboT.LevitonG. L.WrightB. A., Adjustment to Misfortune – A Problem of Social Psychological Adjustment, Art. Limbs, 3, pp. 4–62, 1956.
22.
MercerJ. R., Who Is Normal? Two Perspectives on Mild Mental Retardation, JacoE. G. (ed.), Patients, Physicians, and Illness, Free Press, New York, 1972.
23.
WrightB., Physical Disability – A Psychological Approach, Harper Brothers, New York, 1960.
24.
KrusenF. H., Concepts in Rehabilitation of the Handicapped, W. B. Saunders Co., Philadelphia, 1964.
25.
AdamsW.LindemannR., Coping With Long Term Disability, CoelhoJ. (ed.), Coping and Adaptation, Aldine, Chicago, 1974.
26.
Safilios-RothschildC., The Sociology and Social Psychology of Disability and Rehabilitation, Random House, New York, 1970.
27.
StarkeyP., Sick-Role Retention as a Factor in Non-Rehabilitation, StubbinsJ. (ed.), Social and Psychological Aspects of Disability, University Park Press, Baltimore, 1977.
28.
ParsonsT., Definitions of Health and Illness, JacoE. G. (ed.), Patients, Physicians, and Illness, Free Press, New York, 1958.
29.
MechanicD., The Concept of Illness Behavior, J. Chronic Dis., 15, pp. 189–194, 1962.
30.
TwaddleA. C., The Concepts of the Sick Role and Illness Behavior, Adv. Psychosom. Med., 8, pp. 162–179, 1972.
31.
AbramH., The “Uncooperative” Hemodialysis Patient, LevyH. B. (ed.), Living or Dying, Wiley, New York, 1974.
32.
AlexanderL., The Double Bind Theory and Hemodialysis, Arch. Gen. Psychiat., 33, p. 1353, 1976.
33.
LivesleyW. J., Psychiatric Disturbance and Chronic Hemodialysis, Brit. J. Psychiat., 136, p. 1330, 1979.
34.
PritchardM., Reaction to Illness in Long Term Hemodialysis, J. Psychosom. Res., 18, pp. 55–67, 1974.
35.
PritchardM., Dimensions of Illness Behavior in Long-Term Hemodialysis, J. Psychosom. Res., 18, pp. 351–356, 1974.
36.
PritchardM., Meaning of Illness and Patients' Response to Long Term Hemodialysis, J. Psychosom. Res., 18, pp. 457–464, 1974.
37.
PritchardM., Further Studies of Illness Behaviour in Long Term Hemodialysis, J. Psychosom. Res., 21, pp. 41–48, 1977.
38.
PritchardM., Measurement of Illness Behaviour in Patients on Hemodialysis and Awaiting Cardiac Surgery, J. Psychosom. Res., 23, pp. 117–130, 1979.
39.
LipowskiZ. J., Physical Illness, the Individual and the Coping Process, Psychiat. Med., 1, p. 91, 1970.
40.
JenkinsP.GutmannF.ReilsbachR., Self-Hemodialysis, Arch. Intern. Med., 136, pp. 357–361, 1976.
41.
Kaplan-De-NourA.ShananJ.GartyI., Coping Behavior and Intelligence in the Prediction of Vocational Rehabilitation of Dialysis Patients, Int. J. Psychiat. in Med., 8:2, pp. 145–158, 1978.
42.
MilneJ. F.GoldenJ. S.FibusL., Sexual Dysfunction in Renal Failure: A Survey of Chronic Hemodialysis Patients, Int. J. Psychiat. in Med., 8:4, pp. 335–345, 1978.
43.
SpherW.SartoriusH.BerglundK.HjorthB.KablitzC.PlogiU.WiedemannP. H.ZapfK., EEG and Hemodialysis: A Structural Survey of EEG Spectral Analysis, Hjorth's EEG Descriptors, Blood Variables, and Psychological Data, Electroenceph. Clin. Neurophysio., 43, pp. 78–797, 1977.
44.
MillerF.PattersonM., Psychiatric Complications of Renal Dialysis Disequilibrium: Case Report, Amer. J. Psychiat., 136, p. 1330, 1979.
45.
BeniakT. E., The Assessment of Cognitive Deficits in Uremia, Diss. Absts., 38:12-B, p. 6134, 1978.
46.
GreenbergM. D., Organicity and Psychological Deficit in Hemodialysis Patients: Effects on Personality and Adjustment, Diss. Absts., 37:7-B, pp. 3603–3604, 1976.
47.
MarshallJ. R., Neuropsychiatric Aspects of Renal Failure, J. Clin. Psychiat., 40, pp. 81–85, 1979.
48.
ScheiberS. C.ZiesatH., Clinical and Psychological Test Findings in Cerebral Dyspraxia Associated with Hemodialysis, J. Nerv. Ment. Dis., 162, pp. 212–214, 1976.
49.
RosserR., Depression During Renal Dialysis and Following Transplantation, Proc. Royal Soc. Med., 69, pp. 20–22, 1976.
50.
RatnerD.AdamsK. M.RourkeB. P., The Effects of Hemodialysis on the Cognitive and Sensory-Motor Functioning of the Adult Chronic Hemodialysis Patient, paper presented at the American Psychological Association Convention, Montreal, 1980.
51.
Kaplan-De-NourA.CzaczkesJ., The Influence of Patient's Personality on Adjustment to Chronic Dialysis, J. Nerv. Ment. Dis., 162, pp. 323–333, 1976.
52.
ShortM.AlexanderR., Psychiatric Considerations for Center and Home Hemodialysis, Southern Med. J., 62, pp. 1476–1478, 1969.
53.
WrightR.SandP.LivingstonG., Psychological Stress During Hemodialysis for Chronic Renal Failure, Ann. Intern. Med., 64, pp. 611–621, 1966.
54.
AbramH., The Psychiatrist, The Treatment of Chronic Renal Failure, and the Prolongation of Life: I, Amer. J. Psychiat., 124, pp. 1351–1358, 1968.
55.
AbramH., The Psychiatrist, The Treatment of Chronic Renal Failure, and the Prolongation of Life: II, Amer. J. Psychiat., 126, pp. 157–167, 1969.
56.
KnollP. D.PortF. K.SilkK. P., Hemodialysis in Schizophrenia: A Negative Report, J. Nerv. Ment. Dis., 166, pp. 291–293, 1978.
57.
WeddingtonW. W., Can Dialysis Help the Chronic Schizophrenic?, Amer. J. Psychiat., 134, p. 1310, 1977.
58.
WagemakerH.CadeR., The Use of Hemodialysis in Chronic Schizophrenia, Amer. J. Psychiat., 134, pp. 684–685, 1977.
59.
PortF. K.KnollP. D.SwartzR. D., The Effect of Hemodialysis on Schizophrenia: A Survey of Patients with Renal Failure, Amer. J. Psychiat., 136, pp. 743–744, 1978.
60.
JamesN. M.HearnM. T. W., Hemodialysis, Endorphins and Schizophrenia, Amer. J. Psychiat., 137, pp. 488–489, 1980.
61.
StreltzerJ.MarkhoffR.YanoB., Maintenance Hemodialysis in Patients with Pre-Existing Psychiatric Disorders, J. Nerv. Ment. Dis., 164, pp. 414–418, 1977.
62.
MooreG., Who Should Be Dialyzed?, Amer. J. Psychiat., 127, pp. 1208–1209, 1971.
63.
RaeA.BarnettB.DavidsonR.BlaggC., Hemodialysis in the Home: A Progress Report, Proc. Europ. Dial. and Trans. Assoc., 4, p. 28, 1967.
64.
ShapiroF.SchwabachA., Rehabilitation: Its Implementation and Effectiveness in a Dialysis Setting, J. Chronic Dis., 26, pp. 613–616, 1973.
BaillodR.MooreheadJ., Review of Ten Years' Home Dialysis, Proc. Europ. Dial. and Trans. Assoc., 11, pp. 68–76, 1974.
67.
HullA. R., 1976 Concepts of Hemodialysis, Arch. Intern. Med., 136, pp. 365–366, 1976.
68.
BaillodR., Home Dialysis or Transplantation, Clin. Nephro., 4, pp. 189–193, 1973.
69.
JohnsonW.HathawayD.AndersonC., Hemodialysis – Comparison of Treatment in the Medical Center, Community Hospital, and Home, Arch. Gen. Psychiat., 125, pp. 462–467, 1970.
70.
MooreheadJ.BaillodR.HopewellJ., Survival Rates of Patients Treated by Home and Hospital Dialysis and Cadaveric Renal Transplantation, Brit. Med. J., 4, pp. 83–85, 1970.
71.
SweatmanA.BaillodR.MooreheadJ., Comparison of Home Dialysis and Other Treatments for Chronic Renal Failure, Practitioner, 212, pp. 56–66, 1974.
72.
BaileyG. L.MocelinA.HampersC., Home Dialysis 30,000 Treatments Later, Postgraduate Med., 52, pp. 190–194, 1972.
73.
FriedmanE.GoodwinN.ChaudryL., Psychosocial Adjustment to Maintenance Hemodialysis: Part I, N. Y. St. J. of Med., 70, pp. 629–637, 1970.
74.
Proceedings of the 10th Congress of the European Dialysis and Transplantation Association, Abstracts (extracorporeal), 3, pp. 64–65, 1973.
75.
HampersC.SchupakE., Long-Term Hemodialysis, Grune & Stratton, New York, 1973.
76.
FishmanD.SchneiderC., Predicting Emotional Adjustment in Home Dialysis Patients and Their Relatives, J. Chronic Dis., 25, pp. 99–109, 1972.
77.
LevenbergS. B.JenkinsD.WendorfD. J., Studies in Family-Oriented Crisis Intervention with Hemodialysis Patients, Int. J. Psychiat. in Med., 9, pp. 83–92, 1978.
78.
LevenbergS. B.CampbellL., An Eriksonian Approach to Long-Term Adjustment to Hemodialysis, J. Amer. Assn. Nephro. Nurses and Techs., 4, pp. 19–23, 1977.
79.
EvansR. W., Children of Dialysis Patients and Selection of Dialysis Setting, Amer. J. Psychiat., 135, pp. 343–345, 1978.
80.
SmithE.CurtisJ.McDonaldS.de WardenerH., Hemodialysis in the Home, Lancet, pp. 614–617, March 1969.
81.
HampersC.MerrillJ.CameronE., Hemodialysis in the Home: A Family Affair, Trans. Amer. Soc. Art. Intern. Organs, 11, p. 3, 1965.
82.
ScambaughP.HampersC.BaileyG.SnyderD.MerrillJ., Hemodialysis in the Home – Emotional Impact on the Spouse, Trans. Amer. Soc. Intern. Organs, 13, pp. 41–45, 1967.
83.
StreltzerJ.FinkelsteinF.FeigenbaumH., The Spouse's Role in Home Hemodialysis, Arch. Gen. Psychiat., 33, pp. 55–58, 1976.
84.
EngelG.SchmaleA., Psychoanalytic Theory of Somatic Disorder, J. Amer. Psychoanal. Ass., 15, pp. 344–365, 1967.
85.
EisendrathR., The Role of Grief and Fear in the Death of Kidney Transplant Patients, Amer. J. Psychiat., 126, p. 129, 1969.
86.
AbramH.MooreG.WesterveltF., Suicidal Behavior in Chronic Dialysis Patients, Amer. J. Psychiat., 127, pp. 1199–1204, 1971.
87.
PentacostR., Family Study in Home Dialysis, Arch. Gen. Psychiat., 22, pp. 538–546, 1970.
88.
Kaplan-De-NourA.FisherG.MassM.CzaczkesJ., Diagnosis and Therapy of Families of Patients on Chronic Hemodialysis, Ment. Health and Soc., 1, pp. 251–256, 1974.
89.
MaurinJ.SchenkelJ., A Study of the Family Unit's Response to Hemodialysis, J. Psychosom. Res., 20, pp. 169–177, 1976.
90.
SchupakE.SullivanJ.LeeD., Chronic Hemodialysis in “Unselected” Patients, Ann. Intern. Med., 67, pp. 708–717, 1967.
91.
CrammondW.KnightP.LawrenceJ.HigginsB.CourtJ.MacNamaraI.ClarksonA.MillerC., Psychobiological Aspects of the Management of Chronic Renal Failure, Brit. Med. J., 1, pp. 539–543, 1968.
92.
BlakelyK., Chronic Renal Failure: A Study of Death Anxiety in Dialysis and Kidney Transplant Patients, unpublished doctoral dissertation, University of Manitoba, 1977.
93.
MassM.Kaplan-De-NourA., Reactions of Families to Chronic Hemodialysis, Psychother. Psychosom., 26, pp. 20–26, 1975.
94.
CrammondW.KnightP.LawrenceJ., The Psychiatric Contribution to a Renal Unit Undertaking Chronic Hemodialysis and Renal Hemotransplantation, Brit. J. Psychiat., 113, pp. 1201–1212, 1967.
95.
MenziesI.StewartW., Psychiatric Observations on Patients Receiving Regular Dialysis Treatment, Brit. Med. J., 1, pp. 544–547, 1968.
96.
Kaplan-De-NourA.CzaczkesJ., Professional Team Opinion and Personal Bias – A Study of a Chronic Hemodialysis Unit Team, J. Chronic Diseases, 24, pp. 533–541, 1971.
97.
ReitanJ.LewisH., Repeated Dialysis of Indigent Patients for Chronic Renal Failure, Ann. Intern. Med., 64, pp. 284–292, 1966.
98.
DeVeberG.MacDonaldD., Psychosocial Evaluation and Management in Haemodialysis and Transplantation, Proc. Europ. Dial. Trans. Assoc., 6, pp. 140–144, 1969.
99.
AngerD.AngerD. W., Dialysis Ambivalence: A Matter of Life and Death, Amer. J. Nurs., 76, pp. 276–277, 1976.
100.
ArmstrongS. H., The Common Structure of Treatment Staff Attitudes Toward Adolescent Dialysis Patients, Psychother. Psychosom., 26, pp. 322–329, 1975.
101.
KlenowD. J., Staff Based Ideologies in a Hemodialysis Unit, Soc. Sci. and Med., 13, pp. 699–705, 1979.
102.
Kubler-RossE., What Is It Like To Be Dying?, Amer. J. Nurs., 71, pp. 55–61, 1971.
103.
SchulzR.AdermanD., How the Medical Staff Copes with Dying Patients: A Critical Review, Omega, 7, pp. 11–21, 1976.
104.
SandP.LivingstonG.WrightR., Psychological Assessment of Candidates for a Hemodialysis Program, Ann. Intern. Med., 64, pp. 602–610, 1966.
105.
BorkmanT., Hemodialysis Compliance: The Relationship of Staff Estimates of Patients' Intelligence and Understanding to Compliance, Soc. Sci. and Med., 10, pp. 385–392, 1976.
106.
Kaplan-De-NourA.CzaczkesJ.LilosP., A Study of Chronic Hemodialysis Teams – Differences in Team Opinions and Expectations, J. Chron. Dis., 25, p. 441, 1972.
107.
McKegneyF.LangeP., The Decision to No Longer Live on Chronic Hemodialysis, Amer. J. Psychiat., 128, pp. 267–274, 1971.
108.
SheaE.BogdanD.FreemanR.SchreinerG., Hemodialysis for Chronic Renal Failures, Ann. Intern. Med., 62, p. 558, 1965.
109.
RabinowitzS.Vander SpuyH. I. J., Selection Criteria for Dialysis and Renal Transplant, Amer. J. Psychiat., 135, pp. 861–863, 1978.
110.
Kaplan-De-NourA.CzaczkesJ. W., Personality and Adjustment to Chronic Hemodialysis, LevyN. B. (ed.), Living or Dying: Adaptation to Hemodialysis, Charles C. Thomas Publisher, Springfield, Illinois, pp. 102–126, 1974.
111.
AndersonK., The Psychological Aspects of Chronic Hemodialysis, Canadian Psychiat. Assoc. J., 20, pp. 385–391, 1975.
112.
BeardB., The Quality of Life Before and After Renal Transplantation, Dis. Nerv. Sys., 32, pp. 24–31, 1969.
113.
ViedermanM., On the Vicissitudes of the Need for Control in Patients Confronted with Hemodialysis, Comprehens. Psychiat., 19, pp. 455–467, 1978.
114.
ZiarnikJ. P.FreemanC. W.SherrardD. J.CalsynD. A., Psychological Correlates of Survival on Renal Dialysis, J. Nerv. Ment. Dis., 164, pp. 210–213, 1977.
115.
ReichsmanI.LevyN., Problems in Adjustment to Maintenance Hemodialysis, Arch. Intern. Med., 130, pp. 859–865, 1972.
116.
Kubler-RossE., On Death and Dying, MacMillan Publishing, New York, 1969.
117.
WhiteR. W., The Abnormal Personality, Ronald Press, New York, 1964.
118.
WilsonC. J.MuzekariL. H.SchnepsS. A.WilsonD. M., Time-Limited Group Counseling for Chronic Home Hemodialysis Patients, J. Counsel. Psych., 21, pp. 376–379, 1974.
119.
NortonC., Attitudes Toward Living and Dying in Patients on Chronic Hemodialysis, Ann. N. Y. Acad. of Sci., 164, pp. 720–732, 1969.
120.
NorrisA., Personality Factors in the Performance of Dialysis Patients, Unpublished manuscript, University of Iowa, 1968.
121.
FenichelO., The Psychoanalytic Theory of Neurosis, W. W. Norton & Co., New York, 1945.
122.
SvilandM. A. P., Assessing Adaptive Denial in Home Hemodialysis, Paper presented at the 80th Annual Convention of The American Psychological Association, Honolulu, Hawaii, 1972.
123.
ArmstrongS. H.HendrizE. M., Character Defenses and Biofeedback, Psychother. Psychosom., 27, pp. 205–209, 1977.
124.
Kaplan-De-NourA.CzaczkesJ., Psychological and Psychiatric Observations on Patients in Chronic Hemodialysis, Proc. Europ. Dial. and Trans. Assoc., 5, pp. 67–70, 1968.
125.
MischelW., Introduction to Personality, Holt, Rinehart & Winston, New York, 1971.
126.
WalkerP.GinnH.JohnsonH.StoneW.TeschamR.LatosD.StouderD.LamberthE.O'BrienK., Long Term Hemodialysis for Patients Over 50, Geriatrics, 31, pp. 55–61, 1976.
127.
CohenS.ComtyC.ShapiroF., The Effect of Age On The Results of Regular Hemodialysis Treatment, Proc. Europ. Dial. and Trans. Assoc., 7, pp. 254–260, 1970.
128.
AdlerD. I., Psychosocial Characteristics of Successfully Adapted and Unsuccessfully Adapted Hemodialysis Patients, Diss. Absts., 36:6-B, p. 3018, 1975.
129.
SamuelsS.CharraB.OlheiserK.BlaggC., Twelve Years Experience of Treatment of Chronic Renal Failure, Trans. Amer. Soc. Art. Intern. Organs, 20, pp. 62–66, 1974.
130.
HenariF.GowerP.CurtisJ.EastwoodJ.PhillipsM.GreatbachM.WilliamsG.GordonE.BoydP.StubbsR.De WardenerH., Survival in 200 Patients Treated by Haemodialysis and Renal Transplantation, Brit. Med. J., 1, pp. 409–412, 1977.
131.
LowenhauptE., Psychic Reactions to Long-Term Hemodialysis: Evaluation in the Elderly by Means of the Draw-A-Person Test, J. Amer. Geriat. Soc., 17, pp. 358–363, 1977.
132.
AltrocchiJ., Abnormal Behavior, Harcourt Brace Jovanovich, New York, 1980.
133.
HersenM.BarlowD. H., Single Case Experimental Designs, Pergamon Press, New York, 1976.
134.
YaradigaE. H.StreltzerJ., Limitations of Psychological Tests in a Dialysis Population, Psychosom. Med., 41, pp. 557–567, 1979.
135.
HarrisR. J., A Primer of Multivariate Statistics, Academic Press, New York, 1975.
136.
TatsuokaM. M., Multivariate Analysis, Wiley, New York, 1971.
137.
SundbergN.SnowdenL.ReynoldsW. M., Toward Assessment of Personal Competence and Incompetence in Life Situations, Ann. Rev. of Psych., 29, pp. 179–221, 1978.
138.
CampbellA.ConverseP. E.RodgersW. L., The Quality of American Life, Russell Sage, New York, 1976.