Quality of life and dialysis

The constitution of the World Health Organization defined health as “a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity”. Consequently, quality of life is a multidimensional concept that pertains to the person's perception of his physical condition as well as his mental and social well-being according to the ​system of values of the society which he lives in, in relation to personal objectives, expectations and standards.

The care of patients with Chronic Kidney Disease is a specialized issue in the health sector since the influence of CKD greatly affects the quality of the patient’s life organically and psychosocially. CKD disturbs a person's balance not only biologically, but also has an effect at his social as well as his psycho-emotional functioning and behavior. In addition to physical condition, the areas of work, interpersonal relationships, day-to-day activities and patient’s psychological status are overburdened while the patient may be confronted with concomitant diseases such as infections. The psychological condition of the patient is largely influenced, resulting in mood disorders, sleep disorders, limited social interaction, introversion, modifications in the roles within the family, lack of mood and desire to participate in delightful activities, sexual dysfunction, anger and aggression, sexual dysfunction, development of anxiety disorders and phobias.

Factors that correlate with the dimensions of the quality of the patients’ life are gender, age, marital status, economic situation, as well as educational level. The impact of the family’s patient has a crucial role in improving his psychological state contributing to his social integration, so the constant support by his relatives is imperative, as the kidney patient often feels unable to cope with the needs and desires of the group, and tends to feel inferior and believes that he must hide his illness. This results in a sense of denial to participate in activities, pause of his daily routine and habits, suspension of exercise or fear of taking a vacation. All these changes, instead of helping the kidney patient, tend to change his identity and make him feel permanently ill, and alienated from his family.

The continuous training of patients with CKD and their families is the basis for the optimum treatment, since the sooner the patient understands the nature of the disease and the importance of good cooperation with the medical and nursing staff and he overcomes his fears and anxieties, the better he experiences the changes resulting in a new way of living and enrichment of his quality of life. For instance, many patients express fear regarding exercise, although it is considered beneficial. Research has indicated that systematic exercise contributes to improved body composition, increases cardiorespiratory resistance, improves sleep quality and decreases depression levels, while patient cardiac markers and, in general, all indicators related to their quality of life are also improved.

People suffering from kidney disease and undergoing dialysis treatment are a certain population group with increased need for medical care. However, the evolution of medical science in technological advances as far as the hemodialysis equipment, filter-membrane and medication are concerned, has greatly improved not only the life expectancy of patients with chronic kidney disease but also their quality of life. In addition, the role of the nursing staff is considered prominent providing holistic care including all areas of patients' life and their families combined with psychological support contributes to the development of the patient’s realistic approach to adapt to a new lifestyle and overcome the negative aspects of his treatment.

Eleni Soltaridou, Psychologist at Mesogeios Dialysis Centers Group

Bibliography

Paraskevi Theofilou: Quality of life of dialysis patients, PhD Thesis. Panteion UniversityAthens, Psychology Department, 2010

Panagiotis M. Kokosalis: Study of health-related quality of life and quality of sleep in patients with CKD, Diploma Thesis. Hellenic Open University, School of Social Sciences, 2016

Anna Dimitriadi: CKD, quality of life, role of the nurse, Diploma Thesis, Technological Education Institute (TEI) of Western Greece, School of Occupational Health and Wealfare - Nursing Department, 2015

Anthoula Koutoulaki, Maria Xanthaki: Quality of life of dialysis patients and their families. Technological Educational Institute (TEI) of Athens, School of Occupational Health and Welfare (SEYP) - Department of Social Work, Diploma Thesis, 2011

Aglaia - Eirini Leni, Maria Tourkogianni, Areti Stavropoulou, Ζacharias Zidianakis: Quality of life of patients with chronic kidney disease, research article, Perioperative Nursing, 2 (2), 2013

Bernard G. Jaar, Alex Chang, Laura Plantinga: Can We Improve Quality of Life of Patients on Dialysis? Critical Journal of the American Society of Nephrology, 8 (1): 1-4, 2013

World Health Organization: Preamble to the Constitution of the World Health Organization as adopted by the International Health Conference, New York, 19–22 June, 1946. In: Constitution of the World Health Organization, Geneva, Switzerland, World Health Organization, 100, 1948

 
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