Identification of stress in chronic haemodialysis

Background: Haemodialysis results in a marked change in the quality of patients’ life, since it includes a number of modifications and restrictions, which affect patients’ health functioning. End Stage Renal Disease (ESRD) is an irreversible kidney failure, mainly caused by diabetes, hypertension, glomerulonephritis, and polycystic kidney disease. Haemodialysis is the most frequent treatment method for ESRD. However, it has been argued that a number of restrictions and modifications accompany this treatment, which have a detrimental impact on the quality of patients’ life and affects individuals' physical and psychological well‐being. Aim: The purpose of this literature review was to investigate the stressors experienced by people undergoing haemodialysis. Method and Material: Literature review was based on studies and reviews conducted during the period 1994‐2009, derived from international (Medline, PubMed, Cinahl) databases concerning stressors of haemodialysis. Key‐words were used: haemodialysis, complications, psychological stressors, physiological stressors, psychiatric disorders. Results: The most frequently reported psychological concerns are food and fluid restrictions, unemployment, sexual problems, changes in body appearance, limitation in physical activities, frequent hospitalisations, the length of time on dialysis, uncertainty about the future, changes in life style, increased dependence, and sleep disturbances. Regarding the physiological stressors, the most frequently revealed from the literature are fatigue, pain during venepuncture, muscle cramps, itching between treatments, nausea and vomiting. Conclusions: The topic of stressors is of particular importance among patients receiving dialysis, as these affect their psychological and physiological wellbeing. Thus, the nephrology nurse plays an important role in providing patients with effective psychological support.