Psycho-social influence on self-care of the hemodialysis patient

Abstract

The purpose of this paper is to clarify the psycho-social factors needed for chronic hemodialysis patients to properly engage in self-care behaviors for diet and other matters. The hypotheses concerning the psycho-social factors of self-care for hematocrit, water, sodium and potassium were verified. This study has yielded several results, of which the following four are the most important. First, since patients engage in many kinds of self-care behaviors--some effectively and others not so--it is important that we distinguish them according to their effectiveness. Some patients are in fact doing things every day that are actually detrimental to their health. Second, the physical patient's conditions, 'behavioral senses' regarding his habits, and the criticisms he receives in his work place generally tend to interfere with his self-care behaviors. Yet those who are aware of its influence and who try hard to overcome it tend to be more successful than those who are less aware and do not try as hard. Moreover, the factor that distinguishes these two types of patient is their personality characteristic of perceived 'external-internal locus of control over what happens to them'. Thus it is important to perceive the 'internal locus of control'. Fourth, since the patient's feeling that life is meaningful enables him to actively pursue self-care efforts, such a feeling helps bring about favorable medical test scores. And whether the patient is able to develop a feeling that his life is meaningful is closely related to his family and work. Therefore, it can be said that the patient will need to be provided with such psychosocial support as helping him to solve whatever problem he may have in his family and job, so that he may feel that 'life is meaningful'.