Psychological maladjustment, quality of life and coping in diabetic patients with chronic renal failure in peritoneal dialysis

It has been reported that the impact of the continuous ambulatory peritoneal dialysis (CAPD) procedure in the patient's quality of life has profound psychosocial consequences for him and his family. This replacement of renal function supports survival but not a complete physical, emotional and social development. These aspects may be crucial to the success of treatment with CAPD for its positive or negative influence on patient adherence to this procedure. This study evaluated the degree of psychological maladjustment in CAPD patients, psychosocial variables, coping strategies and the impact on their quality of life. We interviewed 83 patients on CAPD (43 women and 40 men, mean age, 53.5 years, SD, 15.3), chosen for availability in a dialysis unit of a general hospital. Quality of life was inversely and significantly associated with depression, anxiety and loneliness. Spirituality based on a full relationship with life is inversely associated with depression, hopelessness, suicidal ideation, loneliness and death anxiety. Depression, hopelessness and loneliness were associated with a cognitive-dysfunctional coping style. The loneliness and suicidal ideation are associated with a emotional-aggressive coping style the perceived ability of giving and spirituality based on life are associated with positive cognitive coping. When comparing subjects with a high degree of psychological maladjustment, against a norm group, the subjects showed higher mean depression and hopelessness. The results are consistent with findings reported in other latitudes, demonstrating the need to implement intervention strategies aimed at reducing the risk of suicide and to create a better psychological adjustment to the situation of CAPD.