Strategies for coping with stress related to intradialytic events utilized by patients on hemodialysis at the renal unit, Kenyatta National Hospital.
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Date
2020Author
Muthoka, Lydia Ndanu
Type
ThesisLanguage
enMetadata
Show full item recordAbstract
BACKGROUND: Chronic Kidney Disease (CKD) prevalence has increased immensely,
estimated at 8-16% globally, consequently resulting in large numbers of patients with end stage
renal disease (ESRD) requiring renal replacement therapy (RRT). Hemodialysis (HD) is mostly
used in the developing countries like Kenya. Hemodialysis is linked with complications that
affects the quality of life of these patients. These complications are stressful to the patients,
requiring them to cope. Coping mechanisms are broadly categorised into problem focused and
emotion focused. Most patients on HD tend to use emotion-oriented coping strategies to cope
with stress. Emotion focused strategies have been associated with poor therapy outcome and low
health related quality of life. This study aimed at identifying the strategies utilised by patients on
hemodialysis at Kenyatta National Hospital to cope with stress related to intradialytic
complications.
OBJECTIVE: To identifying the coping strategies used by patients to cope with intradialytic
related stress, and to also determine the common types of intradialytic complications experienced
at the renal unit as well as the level of stress.
METHODOLOGY: Quantitative cross-sectional study design was used to meet the objectives
of this study. A researcher administered questionnaire was used to obtain demographic and
clinical data. Jalowiec coping scale was used to identify coping strategies. 96 respondents were
recruited using random sampling method.
RESULTS: Majority (61.5%) of the respondents were male, married (58.3%) and aged (33.3%)
between 40 to 49 years. Respondents with hypertension were the majority (63%). Majority
(89.6%) of the respondents reported to have experienced IDEs more than once in the past 3
months. Most (51%) respondents reported that they had never been guided on ways of coping
with stress related to IDEs. Muscle cramps (55%), headaches (54%) and hypertension (47%)
were the most common experienced intradialytic complications among the respondents. The
mean level of stress was rated at 5.13±2.1 and the commonly used coping strategies were
confrontive (45%), fatalistic (46%) and supportant (48%). There was a statistical significance
(p≤0.05) found in the relationship between the level of stress experienced and the use of coping
strategies.
CONCLUSION: Hypertension is the main cause of CKD among the patients. Central venous
catheters are the main venous access used by the patients for HD. Muscle cramps, headaches and
hypertension are the most common intradialytic complications experienced. Patients are not
adequately informed of the intradialytic complications and are not trained on stress coping
mechanisms. There is need for trainings on stress management and coping. Emphasis on use of
problem focused coping strategies is required through tailored counselling services.
Publisher
University of Nairobi
Rights
Attribution-NonCommercial-NoDerivs 3.0 United StatesUsage Rights
http://creativecommons.org/licenses/by-nc-nd/3.0/us/Collections
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