Psychological and physiological problems a person with a chronic disease has are the focus of health care specialists due to the increasing number of various diseases characterized by a chronic course. The overall objective of clinicians is to help patients to maintain a normal or close to the normal quality of life.
In recent years, the concept of the internal picture of the disease has been actively developed as well as the methods of psychological diagnosis in relation to somatic diseases, and a large amount of empirical psychological work was carried out on patients with chronic kidney disease, diabetes, and other. Any physical illness, particularly, chronic or long-term is accompanied by neuropsychiatric disorders, and it affects the psychological status and personal development of individuals and their family; in this regard, it is crucial to analyze all aspects of the chronic kidney disease in order to speculate on the corresponding measures in the care plan.
Interview Results and Analysis
According to an interview with Mr. X. S (the questionnaire is attached to the document), the disease in his case was caused by two main reasons, which are diabetes and high blood pressure (personal communication, August 10, 2016). Diabetes developed as a consequence of high blood sugar levels, which subsequently caused damage to the kidneys and blood vessels. Hypertension occurred because of or in the course of diabetes (Bomback & Bakris, 2010).
Mr. X. S did not receive any treatment for quite a while, for that reason, the course of illness went rather difficult. Mr. X. S noticed some alarming signs such as fatigue, lack of appetite, sleep disturbances, cramps during sleep, swelling of the feet and ankles, swelling around the eyes, and skin irritation. He was examined when his family members have also noticed the alarming symptoms (X. S., personal communication, 2016).
The course of treatment, in the case of Mr. X.S is synthesized with measures to maintain bone health. The interviewee keeps the diet with a low phosphorus content, takes in phosphate binders and vitamin D with food as well as the corresponding medication. Also, his doctor conducts continuous monitoring of the disease progression (X. S., personal communication, August 10, 2016). In addition, Mr. X. S, along with members of his family, received guidance from a professional nutritionist about proper diet so that he got the right food in the right quantities, and his family members could prevent the development of the disease in their cases. The interviewee constantly interacts with his family and gets emotional and psychological support from them.
It is important to note that the interviewee was observed for several coping skills, which have changed with the acceptance of the disease. In general, coping strategies reflect a person’s ability to identify the problem and to find alternative solutions to deal effectively with stressful situations, thereby contributing to the preservation of both mental and physical health. Coping strategy allows using the current cognitive, emotional, and behavioral responses to cope with a stressful situation successfully (Backman, 2013).
It allows the individual to reduce emotional stress as well as the emotional distress component until a change in the situation itself. Active use of the coping strategies by an individual can be seen as the prevalence of behavioral motivation to succeed but also as a signal of possible intrapersonal conflicts (Daugirdas, 2012). It should be noted that the man showed an adaptive behavioral strategy (X. S., personal communication, 2016). According to interview results, he revealed the following aspects: distraction – reference to any activity and altruism – caring about others when his own needs are sidelined. However, previously Mr. X. S showed active avoidance – avoidance of immersion in the process of treatment and compensation – fulfillment of some of his desires.
Planning Care for the Illness Group
It is worthy of mentioning that the analysis of coping skills is crucial for care plan development for the illness group. As per the results of the interview, it can be evidenced that on the one hand, the individuals with chronic kidney disease utilize the protective mechanisms, and on the other, there is the difference between them in the parameter of activity – passivity (Backman, 2013). The most productive direction during the course of care is the active cooperation of the patient in the diagnosis and treatment process, an active search for support in the therapeutic and social environment.
Further, problem analysis of the disease and its consequences and a reasonable degree of ignoring the disease as well as a humorous approach to it (a certain distancing with regard to disease) are important. It is crucial to note that it is rather difficult to carry out structural modification of psychological defense mechanisms or its removal even if the specialist has created a stable empathic communication with the patient, which weakens and reduces the need for protection.
In this case, the most expedient focus of therapeutic work should be to maintain and develop the patient’s coping mechanisms and skills (Daugirdas, 2012). When planning the course of care, the predominant coping strategies in patients should be self-control, planning solution to the problem, and optimism. The passive and non-constructive strategies of coping with stress such as escape-avoidance, which indicate the quality of the adaptive capabilities of the patients, should be eliminated.
Also, worth noting is that the psychological and physical rehabilitation of patients with chronic kidney disease should be holistic (Backman, 2013). A circular relationship of physical and psychological variables in the course of physical therapy is the manifestation of this relationship. Regular physical exercise will improve the emotional state of patients and increase their satisfaction in the life status (Thomas & Othersen, 2016).
The availability of effective means of overcoming the difficulties, the absence of symptoms of depression and anxiety contribute to the formation of motivation for physical activity (Himmelfarb & Sayegh, 2010). When working with patients, it is advisable to get an idea of the patient’s personal features as they are an important factor in the treatment planning.
The rehabilitation work with patients should be based on a multidisciplinary approach involving physicians, nephrologists, nutritionists, cardiologists, neurologists, physiotherapists, clinical psychologists, and psychotherapists. Psychological support should be combined with regular physical training. Due to the fact that the parameters such as physical functioning and physical health are independent predictors of survival in patients, low physical health self-assessment indicators should alert the doctor and encourage him or her to audit assessment of the somatic condition of the patient and correct the therapy on a timely basis. It is necessary to carry out psychological correction of life values and purposes of patients due to the fact that they are crucial predictors of successful treatment.
Backman, M. (2013). The psychology of the physically ill patient. New York, NY: Springer.
Bomback, A., & Bakris, G. (2010). Chronic kidney disease (CKD) and hypertension essentials. Burlington, MA: Jones & Bartlett Learning.
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Daugirdas, J. (2012). Handbook of chronic kidney disease management. Philadelphia, PA: Lippincott Williams & Wilkins.
Himmelfarb, J., & Sayegh, M. (2010). Chronic kidney disease, dialysis, and transplantation. New York, NY: Elsevier.
Thomas, l., & Othersen, J. (2016). Nutrition therapy for chronic kidney disease. Boca Raton, FL: CRC Press.