IMPACT OF ANXIETY AND TERROR OF DEATH ON QUALITY OF LIFE IN PATIENTS ON CHRONIC HEMODIALYSIS

Authors

  • Olha Shevchuk-Kravchenko Bukovinian State Medical University, Ukraine
  • Oksana Penderetska Bukovinian State Medical University, Ukraine
  • Ivan Garazdiuk Bukovinian State Medical University, Ukraine
  • Oleksandr Garazdiuk Bukovinian State Medical University, Ukraine
  • Viktor Bachynskiy

DOI:

https://doi.org/10.12955/pmp.v1.105

Keywords:

anxiety, hemodialysis, terror of death, quality of life, burnout

Abstract

The aim of the study was to identify the terror of death and anxiety level in patients with end-stage renal disease receiving renal replacement therapy using chronic hemodialysis (HD) and to evaluate the impact of patients' psychological status on medical staff, selection of basic methods of psychotherapeutic care for patients in this category. We involved 37 patients, aged 33-72 years (mean, 45.6 ± 3.8 years). The duration of chronic HD ranged from 8 months to 10 years, with an average of 4.6 years. All the patients had a stable nutritional status, HD regimen and drug therapy for at least 3 months. To diagnose the psychological state of patients we used: the scale of self-assessment of the level of situational and personal anxiety (Spielberger-Hanin’s Scale), personal questionnaire for changes at the onset of HD therapy, elements of a clinical interview, image apperception test (simplified version of Thematic apperception test., Bechterev’s Institute Personal Questionnaire for Diagnosis of Type of Illness (LOBI), Locus of control and personal changes after initiation of HD therapy.

We found that the: adaptation of the patient to HD therapy is complicated due to the high degree of anxiety and maladaptive terror of death, which reduce the patient’s quality of life. The HD procedure increases the level of situational anxiety and requires psycho-correction. HD therapy requires activation of the patient's psychological protection mechanisms, since the dominant protective mechanisms of the psyche in this type of substitution treatment are displacement and negation. The inflexible and rigid use of the latter provokes maladaptive reactions when interacting with healthcare providers, a non-constructive approach to lifestyle choices, work-rest regime, and diet. Patients with a maladaptive mode of adjustment to HD therapy require psychotherapy assistance. There is a need to monitor the psychological status of not only patients, but also medical staff, which due to the specificity of the contingent increases the level of contingent own terror of death. Doctors of HD units require participation in mutual support groups.

Author Biographies

Olha Shevchuk-Kravchenko, Bukovinian State Medical University, Ukraine

Bukovinian State Medical University, Chernivtsi, Ukraine

Oksana Penderetska, Bukovinian State Medical University, Ukraine

Bukovinian State Medical University, Chernivtsi, Ukraine

Ivan Garazdiuk, Bukovinian State Medical University, Ukraine

Bukovinian State Medical University, Chernivtsi, Ukraine

Oleksandr Garazdiuk, Bukovinian State Medical University, Ukraine

Bukovinian State Medical University, Chernivtsi, Ukraine

Viktor Bachynskiy

Bukovinian State Medical University, Chernivtsi, Ukraine

References

Aronow, E., Weiss, K. A., & Reznikoff, M. (2013). A practical guide to the Thematic Apperception Test: The TAT in clinical practice: Routledge.

El Filali, A., Bentata, Y., Ada, N., & Oneib, B. (2017). Depression and anxiety disorders in chronic hemodialysis patients and their quality of life: A cross-sectional study about 106 cases in the northeast of morocco. Saudi J Kidney Dis Transpl, 28(2), 341-348. doi:10.4103/1319-2442.202785

Javadi-Pashaki, N., & Darvishpour, A. (2019). Survey of stress and coping strategies to predict the general health of nursing staff. J Educ Health Promot, 8, 74. doi:10.4103/jehp.jehp_355_18

Lee, V. L., & King, A. H. (2014). Exploring Death Anxiety and Burnout Among Staff Members Who Work In Outpatient Hemodialysis Units. Nephrol Nurs J, 41(5), 479-485, 518.

Lichko, A. (1983). Lichnostnyy oprosnik Bekhterevskogo instituta (LOBI) [Personality Questionnaire of the Bekhterev Institute]. Metody psikhologicheskoy diagnostiki i korrektsii v klinike. Leningrad: Meditsina [Methods of psychological diagnosis and correction in the clinic. Leningrad: Medicine], 312.

McClellan, W. M., Anson, C., Birkeli, K., & Tuttle, E. (1991). Functional status and quality of life: predictors of early mortality among patients entering treatment for end stage renal disease. J Clin Epidemiol, 44(1), 83-89. doi:10.1016/0895-4356(91)90204-m

Roeh, A., Kirchner, S. K., Malchow, B., Maurus, I., Schmitt, A., Falkai, P., & Hasan, A. (2019). Depression in Somatic Disorders: Is There a Beneficial Effect of Exercise? Front Psychiatry, 10, 141. doi:10.3389/fpsyt.2019.00141

Spielberger, C. D. (1983). State-trait anxiety inventory for adults.

Wallston, B. S., Wallston, K. A., Kaplan, G. D., & Maides, S. A. (1976). Development and validation of the health locus of control (HLC) scale. J Consult Clin Psychol, 44(4), 580-585. doi:10.1037//0022-006x.44.4.580

Yalom, I. (1980). Existential Psychotherapy. N.Y.: Basic Books.

Yalom, I. (2008). Staring at the sun: Overcoming the terror of death. The Humanistic Psychologist, 36(3-4), 283-297.

Yalom, I., & Lieberman, M. (1991). Bereavement and heightened existential awareness. Psychiatry, 54(4), 334-345. doi:10.1080/00332747.1991.11024563

Zamanayeva, Y., & Frumkin, A. (2005). Psikhologicheskaya pomoshch' meditsinskomu personalu: postanovka problem i vozmozhnyye puti resheniya [Psychological assistance to medical personnel: statement of problems and possible solutions]. Informatsionnyy byulleten' dlya vrachey gospital'nykh epidemiologov, organizatorov zdravookhraneniya i vrachey drugikh spetsial'nostey. {Information bulletin for doctors of hospital epidemiologists, healthcare organizers and doctors of other specialties.] –St. Petersburg, 2005 – 18 p.

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Published

2020-11-16

How to Cite

Shevchuk-Kravchenko, O. ., Penderetska, O. ., Garazdiuk, I. ., Garazdiuk, O. ., & Bachynskiy, V. . (2020). IMPACT OF ANXIETY AND TERROR OF DEATH ON QUALITY OF LIFE IN PATIENTS ON CHRONIC HEMODIALYSIS . Proceedings of CBU in Medicine and Pharmacy, 1, 97-102. https://doi.org/10.12955/pmp.v1.105