Chronic kidney disease failure (CKD), like all chronic diseases, leads to straining emotional experiences and problematic relationships that worsen the patient’s discomfort. The role of a psychologist can offer valuable and important support for the patient, family members and healthcare workers.
Hemodialysis: a small seismic event…
There are five stages of CKD, beginning with the initial stage of the disease and ending with the terminal stage– terminal uremia, that brings about total and irreversible kidney failure. To compensate for a failed kidney, treatments such as hemodialysis, peritoneal dialysis or kidney transplants are used.
10-15% of the world adult population is affected by this disease.
Despite recent improvements, a patient that begins hemodialysis faces a “small seismic event”, a radical transformation of his or her life. The most typical hardships that hemodialysis patients face are:
- Machine addiction
- Special dietary regime
- Abdominal pain
- Physical transformation
- Change of personal, social and professional objectives
All of these difficulties generate, in one way or another, significant psychological repercussions.
Difficulty with managing emotions
According to a study conducted by F. Miulli Hospital, patients on average reported at least two psychological problems associated with the dialysis experience. The highest percentage of people reported “concern for their own state of health”, followed by “addiction to the hemodialysis machine”, “loss of interest and pleasure in carrying out normal activities”, “fear of sudden/vascular access obstruction”, “difficulty in sustaining personal and psychological autonomy” and “unmotivated mood changes”.
Depression, however, is the most common psychological disturbance, ranking at 20-30%, with terrible repercussions on the health of the patient. The presence of depression, in fact, has a negative impact on the immune system.
Whether it be at a healthcare facility or at home, the role of a psychologist is fundamental in providing emotional support, alleviating suffering and accompanying the patient down this new and insidious path of life.
What does the psychologist do?
At first the psychologist tries to identify any psychosocial and personal difficulties already present in the initial phases of the disease or that were present before the onset of the disease, evaluating how the patient reacts to stressful situations, his or her flexibility in new roles and situations, the transformation of the patient’s role inside the family and his or her degree of autonomy. Subsequently, through dialogue and constant monitoring, the psychologist helps the patient to begin developing new ways to manage daily life, a fundamental process in stabilizing emotions.
Studies have demonstrated that dialysis patients who have received cognitive-behavioral treatment show less symptoms of depression. Similar results have been found in group therapy for dialysis patients (Lii, Tsay and Wang, 2007).
The role of family members and their hardships
The role of family members is decisive in the Patient’s Journey and the psychologist has an important role in offering support for the family too. It is necessary to re-assign roles and modify habits and lifestyles in order to meet the new needs and limitations “imposed” by the patient. Family members experience a wave of emotions as well- anxiety for the future, frustration that there is no definite cure for the disease and social isolation (especially when a family member is taking care of a patient all alone). These factors must be dealt with and a psychologist can offer the support that is needed.
Support for healthcare workers
Finally, the psychologist, if included inside a team made up of healthcare professionals (the so-called “multidisciplinary team” addressed to in a specific article), can even assist medical personnel. It is important to remember that healthcare workers are continuously forced to deal with suffering and matters associated loss or death, which inevitably generates emotional stress. A psychologist can help lessen the emotional and stressful impact of dealing with a patient, guaranteeing better care for the patient as well.
Relieving the emotional suffering of a hemodialysis patient, or any patient affected by a chronic disease, means humanizing medical assistance and recognizing a patient’s right to care, not only regarding physical needs, but psychological and emotional needs as well. This is the idea we uphold in our Patient Support Programs.
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