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An investigation into body image disturbances in adult end-stage renal failure patients undergoing dialysis.

By Kate Alexandra Partridge

Abstract

Literature review: Increased use of medical-technology has led to the creation of a group of individuals who are dependent on, but not cured by technology and who report high levels of iatrogenic side-effects, morbidity and mortality. The experiences of such individuals were explored using a transparent and systematic literature search. Studies were appraised for quality and narrative synthesis used to describe common themes identified by thematic analysis. Themes identified were: coming to terms with the need for medical-technology, issues of power and control, reactions to medicaltechnology, accepting the impacts of medical-technology and continuing to live with technology. Denial and ambivalence prevailed across all themes and individuals struggled to express the conflicting feelings they experienced. The clinical implications of the findings are discussed and possible areas for research identified.\ud Research Report: Individuals with end-stage renal failure rely on dialysis to replicate the function of the kidneys to stay alive. Dialysis-users report high levels of psychological morbidity, significant detrimental impacts in all areas of life and there is evidence to suggest they experience body-image changes. Psychological morbidity is associated with poorer quality of life and increased mortality and body-image changes are associated with elevated psychological morbidity in other chronically-ill populations. The Selfregulatory Executive Function (S-REF) model offers an explanation for these findings with specific reference to cognitive-schemas and self-focus. Mixed methodology was used to identify the prevalence of body-image disturbance in 97 adult haemodialysis and peritoneal dialysis patients and investigate any association between body-image\ud and psychological morbidity. Aspects of appearance-schemas and self-consciousness were also investigated with regard possible influence on both psychological morbidity and body-image disturbance. Participants described wide-ranging impacts of dialysisrelated body changes and high levels of psychological morbidity and body-image\ud disturbance were reported which were significantly associated. Facets of appearance-schematisation and self-focus were significantly associated with psychological\ud morbidity and body-image disturbance. Implications for clinical practice are discussed\ud and future areas for research identified.\ud Critical Appraisal: Reflections are made on the research process with particular consideration of the impact of participant narratives on the Researcher and of the Researcher’s impact on the project. Barriers and facilitating factors are discussed and learning outcomes described

Publisher: University of Leicester
Year: 2008
OAI identifier: oai:lra.le.ac.uk:2381/4140

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