[Analysis of continuous ambulatory peritoneal dialysis (CAPD) stressors in CAPD patients]

The purpose of this study is to clarify stressors resulting from continuous ambulatory peritoneal dialysis (CAPD) in CAPD patients and to discuss adaptation to daily life. With reference to the dialysis stressor scale used by Baldree and Masaki et al., a scale for CAPD stressors, consisting of 42 items, was devised, and the stressors were investigated in 56 patients, with the following results: 1) The items rated as high CAPD stressors included the frequency of bag exchange, itch, fatigue, anxiety about the future, and restricted physical activities. Restriction of meal and fluid intake, which are highly-rated stressors in patients on hemodialysis (HD) were not highly-rated stressors in these 56 CAPD patients. Thus, there was a difference between HD and CAPD. 2) The degree of cognition of CAPD stressors increased according to an individual's situation. (1) The presence or absence of an occupation had the greatest effect on the cognition of CAPD stressors. (2) The degrees of cognition of anxiety about the future and work-related difficulties as stressors were high in patients under 60 years of age. (3) The degree of cognition of items related to work as stressors was high in male patients while that of items related to body image as stressors was high in female patients. (4) There was a qualitative difference in stressor congnition between patients with a history of CAPD of shorter than 3 months and those whose history was 3 months or longer. (5) The degree of congnition of infection was also low in patients who suffered from peritonitis. (6) The degree of congnition of symptoms causing physical discomfort was high in patients with diabetic nephropathy. (7) There were significant differences in several variables, in terms of the degree of congnition, among patients with regard to work difficulties and the absence of familial cooperation. On the basis of these results, guidance for patients and their families is necessary.