Anxiety and complications in patients on hemodialysis

Approximately 175 patients at a dialysis unit were screened for entrance into the study; 43 patients were accepted according to the research criteria. These 43 subjects were given the trait anxiety test from the State-Trait Anxiety Inventory by Spielberger, Gorsuch, and Lushene (1968). Subsequently, the subjects with the ten lowest and ten highest scores were followed over two months or a total of 454 dialyses, and observed for hospitalizations, clinic appointments for treatment, and deaths. During dialysis they were observed for: hypotension; nausea and vomiting; fluid overload; infection of vascular access; clotting of vascular access; epistaxis; pain; pruritus; muscle cramps; and headache. The low anxiety group was found to have a significantly greater incidence of hypotension while the high anxiety group had a greater incidence of clinic appointments for treatment, fluid overload, and cramps. The latter group also had a significantly greater incidence of total complications with the exception of hypotension. Implications were made that appropriate nursing intervention might help prevent physical discomforts in patients on hemodialysis.