Repercussões psicossociais e espirituais da doença renal crônica e dos tratamentos de hemodiálise e diálise peritoneal sobre os familiares
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Date
2020-11-26
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Universidade Católica do Salvador
Abstract
Chronic kidney disease causes physical, emotional and social changes in the
person affected, with repercussions on the family, which is subject to the various adaptive
demands imposed by the disease and dialysis therapy. From the literature, quality of life,
spirituality, hope, resilience and social support were highlighted as elements that may be
present and be influenced by illness, and even present themselves differently among family
members of people on hemodialysis and on peritoneal dialysis. General objective: To analyze
the psychosocial and spiritual repercussions that chronic kidney disease and hemodialysis and
peritoneal dialysis treatments can have on the sick person's family members. Method: Mixed
study with qualitative (n = 20) and quantitative (n = 160), descriptive, cross-sectional and
comparative study, carried out with family members of people with chronic kidney disease
undergoing dialysis therapy, in a dialysis unit in Salvador-Bahia, Brazil. Data collection was
carried out from September to December 2019, after approval by the Ethics Committee, using
the following instruments: sociodemographic questionnaire; semi-structured interview script;
WHOQOL-bref; WHOQOL-SRPB; Resilience Scale for Adults; Herth's Hope Scale and
Perceived Social Support Multidimensional Scale. The data obtained from the scales
wereanalyzed with descriptive statistics and association tests adequate to the nature of the
variables. Content analysis was used to treat narratives and discussions were carried out
through the triangulation of methods. Results: illness and treatment repercussions on the
investigated elements were identified and quality of life, spirituality, religiosity and social
support obtained higher scores for the peritoneal dialysis group; while in hope and resilience
the scores had similar values between treatment groups. Negative self-perception of life
quality emerged after the disease and treatment, dealing with it through overcoming
mechanisms, reorganization of family, personal and social everyday life, and through passive
acceptance of the experienced situation. As sources of support, spirituality, religiosity, hope,
and support from family, friends, and health professionals were mentioned. Correlations were
identified showing that age, gender, belief, income and length of care influenced the quality of
life. There were positive correlations between the averages of quality of life domains; general
quality of life index; spirituality, religiosity and personal belief; resilience; hope; and
perceived social support, indicating that the higher the score of one of these elements, the
higher the score of the others. Main conclusions: this study confirm the thesis that the
statistically significant differences in the quality of life of family members of peritoneal
dialysis with a higher score in the environment domain, when compared to those of
hemodialysis, do not occur due to the type of treatment, considering that this treatment causes
greater care overload for the family, but due to the socioeconomic characteristics of the
families of the people who are indicated for the referred treatment. Given the differences in
scores between groups of family members, specific care actions and programs for family
members are required by type of treatment.
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Keywords
Doença renal crônica, Família, Hemodiálise, Diálise peritoneal, Qualidade de vida, Espiritualidade, Suporte social, Esperança, Resiliência, Chronic kidney disease, Family, Hemodialysis, Peritoneal dialysis, Quality of life, Spirituality, Social support, Hope, Resilience