Die rol van enkele voorspellers in die sielkundige welstand van pasiënte met kroniese nierversaking

[摘要] English: The diagnosis of chronic renal failure has, besides the physical influence, probably also far reaching consequences on the psychological well-being of these patients. Questions arising from this entail the following: 'What are the levels of psychological well-being of these patients? 'What are the factors that make them more resilient against the impact of their illness? and 'Is there a link between these factors and their levels of psychological well-being? The purpose of this study was first and foremost to describe the psychological well-being of patients with chronic renal failure by addressing it through the framework of positive psychology. Due to the fact that the psychological well-being of patients with chronic renal failure is influenced by various factors, the identification of such factors that help these patients to be more resilient in these situations is of great importance. In this study spirituality, hope and optimism were identified as internal resilience factors. The second aim of the study evolved from this namely, to get an indication of the levels of spirituality, hope and optimism experienced by patients with chronic renal failure. The question if these factors have an impact on the psychological well-being of patients with chronic renal failure, give s rise to the last purpose of the study, namely to determine the influence of these factors on maintaining a relative degree of psychological well-being of patients with chronic renal failure. In order to address these goals, a research group of 120 patients formed part of this study. Due to the fact that chronic renal failure is treated in different ways, the patients were divided into three groups, with 30 patients in each group, according to their treatment modality namely, haemodialysis, peritoneal dialysis and patients that already have had a kidne y transplant. These patients were primarily from nephrology clinics and treated respectively at Universitas- , Mediclinic and Rosepark hospitals in Bloemfontein. The remaining 30 patients diagnosed with an acute illness and admitted in the orthopaedic wards at Pelonomi hospital in Bloemfontein and Ernest Oppenheimer hospital in Welkom, were included in the study as a control group. The quantitative part of the study was done by using quantitative questionnaires which included the following: the Satisfaction with Life Scale (Diener, Emmonds, Larsen & Griffin, 1985), the Selfdetermination Scale (Sheldon & Deci, 1996), the Spiritual Well-Being Scale (Paloutzian & Ellison, 1982), the Herth Hope Index (Herth, 1992), the Affectometer 2 (Kamman & Flett, 1983) and the Attributional Style Questionnaire (Seligman, Abramson, Semmel & von Baeyer, 1979). To complement the quantitative results, a qualitative study was done by conducting interviews with 5 patients out of each of the four groups. These semi-structured interviews aimed to elicit the levels of psychological well-being, spirituality, hope and optimism that were experienced by the research group. The levels of psychological well-being of the research group were described. The quantitative results of the study indicated that the research group had average levels of psychological well-being. Out of the four groups, the kidney transplant patients had the highest levels of psychological well-being. Factors that either heighten or lower the research group's levels of psychological well-being, were indicated. The research group's levels of spirituality, hope and optimism were also described. From the quantitative and qualitative results it appears as if the research group experienced high levels of spirit ual well-being, hope and optimism. The haemodialysis and kidney transplant patients had the highest levels of spiritual well-being whilst the kidney transplant patients and those of the control group had the highest levels of hope and optimism. With regard to the last aim of the study (the influence of spirituality, hope and optimism on the psychological well-being of nephrology patients) optimism was the most prominent antecedent which explained the levels of self-determination for both the nephrology patients as well as the control group. Optimism also explained the satisfaction with life of those patients who already had undergone a surgical procedure (kidney transplant patients and the control group). Spirituality was indicated as an antecedent for the self-determination of the haemodialysis patients as well as the satisfaction with life of the patients of the control group. It is only the haemodialysis patients' hope that explained their self-determination. The findings of this study could possibly be extended to other research through focussing on other antecedents that was used in this study to develop a greater understanding of the factors that influence the nephrology patients' psychological well-being. Through ongoing research in this field , a better understanding for the world of the patient with chronic renal failure can be obtained.

[发布机构] University of the Free State