Denial Defense Mechanism in Dialyzed Patients

Area of Science:

• Nephrology
• Psychology
• Health Outcomes

Background:

• Identifying adaptive coping strategies for disease-related stress is challenging.
• Patients with end-stage renal disease (ESRD) experience significant stress.
• Coping strategy intensity may vary based on renal replacement therapy (RRT) type.

Purpose of the Study:

• To investigate the intensity of coping strategies, including denial, in ESRD patients.
• To determine if coping strategies differ between hemodialysis (HD) and continuous ambulatory peritoneal dialysis (CAPD) patients.

Main Methods:

• 60 HD patients and 55 CAPD patients were assessed using validated psychological inventories.
• Coping strategies, denial mechanisms, and quality of life were measured.
• Dialysis adequacy was assessed via serum biochemistry and hematocrit.

Main Results:

• HD patients reported higher intensity of denial and avoidance coping strategies compared to CAPD patients.
• Cluster analysis identified three coping patterns: 'repressors' (denial/avoidance, predominant in HD), task-oriented, and mixed strategies.
• Health outcomes, anxiety, and mood profiles were similar across all patient groups and coping patterns.

Conclusions:

• Hemodialysis patients predominantly employ 'repressive' coping strategies (denial and avoidance).
• These denial and avoidance strategies contribute to satisfactory quality of life and adherence to RRT.
• Previously underestimated coping mechanisms like denial and avoidance may be beneficial for RRT patients.