[Hemodialysis patients' evaluation of their lives]

The experience of end-stage renal failure (ESRF) should not be understood merely in terms of functional impairment and increases in emotional distress. It should be assessed in its own right. Qualitative research is necessary for describing patients' own experience of ESRF so that findings are not influenced by psychological theory.

The typical sampling method was used to select the sample, which consisted of 16 hemodialysis patients. Thematic analysis of patient interviews followed established conventions so as to ground the analysis in the data, rather than pre-existing ideas.

Qualitative analysis identified different ways in which the patients evaluated their lives. The patients described the effects of ESRF on their lives primarily in terms of attitudes towards limitations, mixed feelings about caregivers, and changes in their own character. Caregivers were frequently described as supportive, but patients also perceived them as sources of distress and difficulty. ESRF and its treatment were reported to have worsened not only the patients' emotional states, but also aspects of their character; however, the effect of ESRF also involved the experience of positive changes in character.

The present study provides a detailed systematic account of how hemodialysis patients evaluated their lives. Some of the findings provide details about how the psychological processes that have been previously reported operate in practice, which clinicians and researchers need to understand; however, some findings cannot readily be explained according to existing ideas. The findings, therefore, identify potential targets for educational intervention to improve patient adjustment.