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Foundations of nephrology nursing.

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Foundations of Nephrology Nursing Angela Adams 200117930 Module Leader: Marty Wright Date of Submission: 16th April 2003 Word Count 2044 This assignment is my own work. It has not been, and will not be presented for assessment for any other module, or piece of work, which accrues credit for the work which I am currently studying. ........................................ Introduction The aim of this essay is to discuss how the diagnosis of chronic renal insufficiency may impact upon a patient's psychosocial wellbeing. Using the appropriate literature to support my discussion I have introduced and identified the need for pre-dialysis education with regards to the management of chronic renal insuffiency. In brief, I have mentioned the choice of therapy/treatments involved regarding chronic renal insufficiency. Identified the family role and contribution in the involvement of patient's acceptance of chronic illness and coping mechanisms and the impact on the individual. Also taken into account the holistic approach necessary on the physical, psychological and social needs of the patient and their family. I have discovered that chronic renal insufficiency patients may be subject to multiple physiological and psychosocial stresses and maybe threatened with many potential losses and lifestyle changes. "The physiological mode of adaptation is inseparable from the psychosocial because the body's' emotional and physical proceeds interact". ...read more.


Patients may initially feel relief at starting dialysis when symptoms of uraemia have been troublesome. However if the onset of dialysis has been sudden an acute crisis phase of adjustment may be experienced, with feeling of shock, disbelief, desperation and depression. Arriving at some level of acceptance is 4 associated with periods of contentment, often alternating with periods of depression. Fricchine et al (1992). Returning to some previously meaningful activity may often facilitate the adaptation process. Many patients experience feelings of intense hopelessness, in their attempts to adapt to the illness. On one hand patients may wish to be passive and dependant, while being expected by the healthcare team to be active and independent and this may promote a feeling of being "trapped"as stated by Reischman and Levy (1997). It is important to understand that such a process is not always clear cut and individual respond differently to the realities of end-stage renal insufficiency. Levvy (1981). Individuals with renal insufficiency are likely to appraise aspects of their environment as damaging or potentially threatening. Therefore renal patients faced with the environment of a dialysis unit and the demands of learning complex life sustaining skills may experience feelings of overwhelming stress. Renal care staff who are required to support patients and their families through the transition process to dialysis care must bear this in mind. ...read more.


Followed by a decrease in social life, uncertainty about the future, fatigue and muscle cramp. Problem solving methods were considered to be more effective than affective measures in dealing with stressors. Quality of life was perceived as below average in both haemodialysis and continuous ambulatory peritoneal dialysis. However, continuous ambulatory peritoneal dialysis patients experience a higher quality of life than haemodialysis patients. The length of time on the dialysis programme was not related to coping behaviour. The findings of this study can further help renal nurses to provide support, information and alternative solutions and to assist the patient to make better use of problem solving methods to enhance the quality of life on dialysis. 9 In conclusion, further studies could be conducted on chronically ill patients to compare their coping mechanisms and quality of life with those of renal patients. To aid renal nurses to further enhance renal patients' quality of life and compliment pre-dialysis education. Chronic renal insufficiency can present with unpredictable and numerous challenges to the patient and their families. Nursing intervention in the psychosocial adaptation process can make a difference to the final outcome. As previously noted, it is recognised that the nurse has the closest contact with the renal patient. As part of the multidisciplinary team an astute and caring nurse may be able to positively alter the patients negative perception of their illness, themselves and responses of others. 1 1 ...read more.

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