Peritoneal dialysis patients of mental health problems

Domestic and international studies have shown that dialysis patients prone to anxiety, depression and other psychological disorders , seriously affecting the quality of life of patients , the clinical course of the disease and rehabilitation . In general, the reaction through the following six stages of mental patients , that suspicion , anger → anxiety, depression → guilt , loss → despair , self-pity , loneliness → dependent enhancement , self-centered strengthen → expect , this is from the patient dialysis began to accept the emotional transition to a stable dialysis patients showed different severity vary.
A cause psychological problems peritoneal dialysis patients the cause
( 1 ) in patients with long-term illness plagued by chronic renal failure , as long medication and did not get satisfactory results , prone to pessimism.
( 2 ) patients to receive dialysis treatment just because of the lack of understanding of the treatment , often overly worried about the success of the various side effects of peritoneal dialysis and dialysis may arise.
( 3 ) after receiving dialysis treatment adverse change in self-image ( such as abdominal dialysis catheter indwelling there , body fat , etc. ) and is often accompanied by decreased libido , impotence , infertility and other phenomena , prone to low self-esteem , paranoia .
( 4 ) With the prolonged dialysis due to low self-esteem , do not want to go home all day , resulting in reduced social activities, so many things to lose interest.
( 5 ) due to physical causes undue reliance on emotions, but the people around him to produce excessive demands , bring the family discord and conflict , increasing the patient's anxiety.
( 6 ) In addition to endure the pain of patients with the disease , the elderly and infirm , barriers to self-care , long-term dialysis economic constraints, lack of care for family members and social support to reduce , easy to produce negative emotions .
( 7 ) the experience of dialysis complications such as peritonitis , the fear of recurrence and complications such as peritonitis increased anxiety.
2 psychological problems affecting patients on peritoneal dialysis
( 1 ) increase the incidence and mortality of cardiovascular disease. The mechanism may be depression increases the risk factor for cardiovascular disease ( such as smoking , diabetes, hypertension ) , increased platelet aggregation, promote micro- inflammatory response .
( 2 ) immune disorders, decreased immunity against pathogens , increasing the risk of infection. Studies have found that the incidence of peritonitis associated with psychological factors , including depression , anxiety, family relationships.
( 3 ) serum albumin (ALB) to reduce malnutrition . This may cause gastrointestinal symptoms and depression itself and inadequate dialysis related.
( 4 ) expansion and somatic symptoms of physical illness social dysfunction . Because of the mental ability to regulate chronic diseases weaken the role of the various psychological factors , will cause physical changes in the new functional, organic is .
( 5 ) poor adherence to treatment , which further aggravate the disease, accelerated disease progression.
3 psychotherapeutic intervention in peritoneal dialysis patients
( A ) health care
① establish good contact with the patient , and always with a sincere attitude towards patients , maintaining equal status with patients , communication with patients should pay attention to create a relaxed environment to talk to the patient a sense of trust and security.
② the initiative to communicate with patients , patient listening intently , so that patients feel valued and cared for , patients with emotional problems caused by looking for a specific event , to help patients to clarify its causes anxiety .
③ respect the patient's subjective experience , protecting patient privacy , to avoid causing unnecessary tension . Inspire patients to be patient , to eliminate the psychological stress and sense of helplessness , encourage patients to build confidence .
④ strengthen health education, so that patients understand their condition correctly , understand the importance and necessity of dialysis treatment , eliminate anxiety and other negative emotions , proactively cooperate with treatment ; improve self-care ability of patients to reduce psychological dependence , avoid the family make excessive demands and generate friction, reduce family conflicts arise. Through regular home visits , telephone hotline set up so that patients experiencing issues can be solved.
( 2 ) family and community
① The family is an important part of social support , good family support is to improve the quality of life of the premise and foundation. Family support comes mainly from the care , understanding and support of the spouse and children , family members can help patients avoid isolated, sad, pessimistic negative emotions, stress buffering patients .
② called on the community to strengthen the focus on peritoneal dialysis patients , reduce discrimination and improve the medical insurance system , reduce the economic pressure.
( 3 ) the patient himself
① take part in social activities to enhance contact between patients and talk , which can make patients get emotional support each other , and to reduce the pressure caused by the disease , allowing patients to establish confident and optimistic state of mind.

② When faced with a problem difficult to solve puzzles in a timely manner or to communicate with family members, relatives and friends and health care , emotional anxiety, depression and when to get in contact with the doctor and seek help , do not suffer in silence .