A quantitative study comparing adjustment and acceptance of illness in adults on renal replacement therapy

Adjustment and acceptance of illness are major factors influencing quality of life in different modes of renal replacement therapy. A quantitative tool was used to compare adjustment and acceptance of illness in adult patients on maintenance dialysis to those with a functioning renal transplant. A questionnaire incorporating Felton's Acceptance of Illness Scale was sent to 273 patients receiving replacement therapy for end stage renal disease (ESRD) in Leicester, UK. The instrument examined the effects of a variety of clinical and social parameters on the Acceptance of Illness Scale Score (AISS). Patients with a functioning renal transplant had a significantly higher AISS than patients on hemodialysis (HD) or peritoneal dialysis (PD) (P < 0.0001). Patients in employment or full-time education had a higher AISS than other patients (P < 0.01). White/Caucasian ethnic origin had a higher AISS than Asian (P = 0.011). There were weak inverse correlations between age and AISS, and between AISS and perception of 'choice' in treatment modality. Health care professionals need to be aware of all variables that affect patient acceptance of illness in order to administer optimum clinical care.