Effects of prolonged stress on coping style in terminal renal failure patients

Fifty-nine patients with terminal renal failure and 59 comparison subjects matched on age, sex, origin, education and marital status were administered the Shanan Sentence Completion Test at the onset of hemodialysis, to test the hypothesis that 1) prolonged stress reduces the tendency to cope actively and that 2) the extent of reduction would vary according to the patients' background. Findings provided massive support for the first hypothesis; in nearly all aspects of coping style investigated, hemodialysis patients obtained significantly lower scores, indicative of passivity, negative self-perception and of tendencies to withdraw by denial from the harsh reality. Findings on the second hypothesis were equivocal. Only sex and education showed interaction with illness and coping. Women appeared to be more vulnerable than men. The effects of education on coping were reduced as a consequence of the illness. Findings are discussed in terms of their implications for stress research and for the advancement of preventive measures in hemodialysis treatment.