Chronic hemodialysis patients' perceptions of stress, coping, and social support

The purpose of this study was to describe chronic hemodialysis patients' perceptions of stressors, coping methods, and social support.

A descriptive survey design was used.

The convenience sample consisted of 129 hemodialysis patients who ranged in age from 20 to 87 years. Subjects were obtained from two hospital-based and two freestanding outpatient hemodialysis centers in the Midwest.

During a hemodialysis treatment, each subject participated in an audiotaped structured interview that had seven open-ended questions about stressors, coping methods, and social support. These interviews were transcribed verbatim and analyzed with content analysis.

Subjects used multiple coping methods such as acceptance, optimism, maintaining control, seeking support, and staying active to handle 62 stressors, which included physiological complications, psychosocial concerns about hemodialysis, and restrictions. Subjects positively evaluated their support and discussed concerns for support persons and needs for more support.

Nurses can conduct ongoing assessments of hemodialysis patients' stressors, coping, and social support so that they can assist patients to alleviate stressors and attain or maintain effective coping methods and support resources. Research can focus on development and testing of specific nursing interventions to assist hemodialysis patients to cope with stressors and strengthen their social support.