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Denial Defense Mechanism in Dialyzed Patients.

Nowak Z, Wańkowicz Z, Laudanski K - Med. Sci. Monit. (2015)

Bottom Line: HD patients predominantly used "repressive" strategies.Patients on RRT utilized denial and avoidance-based strategies to achieve satisfactory outcome in terms of perceived quality of life.We conclude that these coping mechanisms that were previously thought to be inferior are beneficial to patient compliance with RRT.

View Article: PubMed Central - PubMed

Affiliation: Department of Nephrology and Dialysotherapy, Military Institute of Medicine, Warsaw, Poland.

ABSTRACT

Background: It is a struggle to identify the most adaptive coping strategies with disease-mediated stress. Here, we hypothesize that intensity of coping strategies, including denial, in patients with end-stage renal disease (ESRD), varies with type of renal replacement therapy (RRT).

Material and methods: We enrolled 60 in-center hemodialyzed patients (HD) and 55 patients treated with continuous ambulatory peritoneal dialysis (CAPD). We administered the Coping Inventory with Stressful Situation, Profile of Mood States, and Stroop Anxiety Inventory to measure patient coping strategies in the context of their ESRD. Denial defense mechanism was measured via the IBS-R/ED. The Nottingham Health Profile was used to evaluate self-perceived quality of life. Serum potassium, urea, creatinine, phosphorus, calcium, albumin, and hematocrit were utilized as the measurements of adequacy of dialysis.

Results: HD patients had higher self-reported intensity of denial mechanism and avoidance-oriented strategies versus CAPD patients. Because a single strategy is almost never employed, we conducted cluster analysis. We identify 3 patterns of coping strategies using cluster analysis. "Repressors" employed denial and avoidance strategies and were predominant in HD. The second cluster consists of subjects employing predominantly task-oriented strategies with equal distribution among dialyzed patients. The third cluster encompassed a small group of patients who shared higher intensity of both denial and task-oriented strategies. Health-related outcome, anxiety, and mood profile were similar across all patients.

Conclusions: HD patients predominantly used "repressive" strategies. Patients on RRT utilized denial and avoidance-based strategies to achieve satisfactory outcome in terms of perceived quality of life. We conclude that these coping mechanisms that were previously thought to be inferior are beneficial to patient compliance with RRT.

No MeSH data available.


Related in: MedlinePlus

Intensity of defense mechanism in studied populations of ESRD patients.
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f1-medscimonit-21-1798: Intensity of defense mechanism in studied populations of ESRD patients.

Mentions: Following the main hypothesis, we studied the coping mechanisms involved in dealing with ESRD-related stress. HD patients had higher self-reported intensity of denial mechanism compared to the CAPD group (Figure 1). Avoidance-oriented strategies were also more pronounced in the HD group, whereas task-oriented strategies where more prevalent in CAPD subjects (Figure 1). Of note, utilization of avoidance-oriented strategies was related to the level of education when univariate general linear model of ANOVA was analyzed (data not shown). Emotion-oriented strategies had similar intensity in both RRT groups. Again, there was significant interaction between modality and education. Subjects with elementary or higher education level had higher intensity of avoidance-oriented strategies in the hemodialyzed group. In contrast, CAPD subjects utilized avoidance-oriented strategy similarly, regardless of their education. Employment of avoidance-oriented strategies was generally less frequent in the CAPD group as compared to HD patients (Figure 1).


Denial Defense Mechanism in Dialyzed Patients.

Nowak Z, Wańkowicz Z, Laudanski K - Med. Sci. Monit. (2015)

Intensity of defense mechanism in studied populations of ESRD patients.
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4482183&req=5

f1-medscimonit-21-1798: Intensity of defense mechanism in studied populations of ESRD patients.
Mentions: Following the main hypothesis, we studied the coping mechanisms involved in dealing with ESRD-related stress. HD patients had higher self-reported intensity of denial mechanism compared to the CAPD group (Figure 1). Avoidance-oriented strategies were also more pronounced in the HD group, whereas task-oriented strategies where more prevalent in CAPD subjects (Figure 1). Of note, utilization of avoidance-oriented strategies was related to the level of education when univariate general linear model of ANOVA was analyzed (data not shown). Emotion-oriented strategies had similar intensity in both RRT groups. Again, there was significant interaction between modality and education. Subjects with elementary or higher education level had higher intensity of avoidance-oriented strategies in the hemodialyzed group. In contrast, CAPD subjects utilized avoidance-oriented strategy similarly, regardless of their education. Employment of avoidance-oriented strategies was generally less frequent in the CAPD group as compared to HD patients (Figure 1).

Bottom Line: HD patients predominantly used "repressive" strategies.Patients on RRT utilized denial and avoidance-based strategies to achieve satisfactory outcome in terms of perceived quality of life.We conclude that these coping mechanisms that were previously thought to be inferior are beneficial to patient compliance with RRT.

View Article: PubMed Central - PubMed

Affiliation: Department of Nephrology and Dialysotherapy, Military Institute of Medicine, Warsaw, Poland.

ABSTRACT

Background: It is a struggle to identify the most adaptive coping strategies with disease-mediated stress. Here, we hypothesize that intensity of coping strategies, including denial, in patients with end-stage renal disease (ESRD), varies with type of renal replacement therapy (RRT).

Material and methods: We enrolled 60 in-center hemodialyzed patients (HD) and 55 patients treated with continuous ambulatory peritoneal dialysis (CAPD). We administered the Coping Inventory with Stressful Situation, Profile of Mood States, and Stroop Anxiety Inventory to measure patient coping strategies in the context of their ESRD. Denial defense mechanism was measured via the IBS-R/ED. The Nottingham Health Profile was used to evaluate self-perceived quality of life. Serum potassium, urea, creatinine, phosphorus, calcium, albumin, and hematocrit were utilized as the measurements of adequacy of dialysis.

Results: HD patients had higher self-reported intensity of denial mechanism and avoidance-oriented strategies versus CAPD patients. Because a single strategy is almost never employed, we conducted cluster analysis. We identify 3 patterns of coping strategies using cluster analysis. "Repressors" employed denial and avoidance strategies and were predominant in HD. The second cluster consists of subjects employing predominantly task-oriented strategies with equal distribution among dialyzed patients. The third cluster encompassed a small group of patients who shared higher intensity of both denial and task-oriented strategies. Health-related outcome, anxiety, and mood profile were similar across all patients.

Conclusions: HD patients predominantly used "repressive" strategies. Patients on RRT utilized denial and avoidance-based strategies to achieve satisfactory outcome in terms of perceived quality of life. We conclude that these coping mechanisms that were previously thought to be inferior are beneficial to patient compliance with RRT.

No MeSH data available.


Related in: MedlinePlus