Stressors and Coping Strategies among Hemodialysis Patients in Selected Counties Dialysis Centers in Kenya.
Mugi, Elizabeth Wambui
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Patients with chronic kidney disease (CKD) depend on renal replacement modalities that act to substitute the function of the compromised kidney. Hemodialysis remains the most sought form of treatment modality among Patients with CKD. Despite its health benefits, patients receiving hemodialysis services experience multiple physiological, psychological and physical stressors that results into a different level of perceived health status. As a result, the patients develop various individualized and unique coping strategies to help them cope with the disease. Aim: The study aimed at describing the stressors and coping strategies among hemodialysis patients. Methodology: This was a descriptive correlational study among hemodialysis patients in four selected county dialysis centers in Kenya. Sample size was determined through a census method. Data was collected by means of a semi structured questionnaire. Data was analyzed using a Statistical Package for Social Sciences (SPSS) version 25.0 and presented using graphs, frequency tables, and chi-square to test for the significance. Results. The major physiological stressors were decreased sexual drive, feeling tired and difficulties in falling asleep while the major physical stressors were joint pains and being uncomfortable with the physical body changes. Despite government initiative to devolve hemodialysis services, the major psychological stressors were inadequate hemodialysis machines, lack of commodities and difficulties in raising the cost of treatment. Major problem based coping strategies used were sharing with family members, sharing with health care workers and seeing the good side of the problem while the major emotion based strategies used were wishing the problem could go away, blaming others and keeping the problem to one self. There was statistically significant association between sharing with health care worker and perceived health status. There was statistically significant association between problems based strategies and perceived health status. Conclusion and recommendations: Nurse Counsellors should provide counseling to patients prior to start of hemodialysis on the physiological stressors especially issues of decreased sexual drive. Patients should be assessed on the physical stressors by the nurses and doctors to ensure the appropriate remedies are provided. Nurse Counsellors should counsel patients on the use of problem coping strategies as they are significantly associated with better perceived health status. Health workers should also be readily available to listen to the patients’ needs as sharing with health care workers was significantly associated with better perceived health status. Recommend the County government to increase the number of HD machines in line with the number of patients so that to reduce on waiting time