Individuele- en huweliksaanpassing van die nierpasiënt

Abstract

Psigonefrologie behels die studie von psigologiese faktore wat 'n rot speel by eindstadiumnierversaking. Nierversaking word beskou as 'n lewensbedreigende siekte, wat die lewensverwogting von die pasient verkort indien hy nie behandeling ontvang nie. Nierversaking kan ingedeet word in drie stadiums: Die pre-dialise, diatise, en oorplantingstadiums. Die onderskeibaorheid von hierdie stadiums is die gevotg von verski lie in mediese behandelingsmetodes. Nie een hiervon bring genesing nie, maar vertig simptome van die uremiese sindroom, verleng die tewensverwagting von die pasient, en is veronderstel om sy lewenskwaliteit te verbeter. DepresS,ie en angs, is algemene simptome wat by nierpasiente voorkom. Die redes hiervoor, is die pasient se psigologiese reaksie teenoor nierversaking, dialise, en/of 'n oorplanting. Verder moet hy ook die newe-effekte van die mediese behandeling trotseer. Aanpassings moet ook gemaak word in terme von beroep~ en sosiate funksionering. Nie net het eindstodiumnierversaking 'n psigososiate impok op die nierposient nie, maar word die gesonde moat ook daardeur be"invtoed. Daarom ervoar meeste egpore gesamentlik die impok von nierversaking op hulle huwelik- en gesinslewe. Vir optimale oanpassing by nierversaking moet egpore sekere oanpassingstoke bemeester, soos om nierversoking as 'n gedeetde probteem te hanteer, oan te pas by die rot von pasient en versorger. die verskillende behoeftes oan nobyheid en afstand tussen pasient en versorger, en die verwisseting in beroepsrolle hanteer, asook effektiewe kommunikasie met mekoar en die mediese span doarstel, en mekaor deurlopend instrumenteel en emosioneel ondersteun ten einde die huweliksverbintenis in stand te hou. Die resultate von hierdie ondersoek dui doarop dat huweliksverondertikes, soos 'n afnome in ontsponningsaktiwiteite en seksuatiteit, en gelykmakende rolle 'n belangrike rot speel om oanpassing by nierversaking te vergemaklik. Daarmee soam is gevind dat godsdiens 'n belangrike oanpossende funksie vir egpore het. Deurgoans speel'n ondersteuningsisteem, wat uit famitie en vriende, onder nierpasiente, die mediese span en 'n sielkundige bestoan 'n vernome rol om die egpoar met oanpassing te help. Uiteindelik blyk dit moonttik te wees vir egpare om hulle huwetiksverhouding in stand te hou, of setfs konstruktief te herstruktureer, asook groter huwelikstevredenheid te ervoar, ondanks die bedreiging von eindstadiumnierversaking. Meeste egpore ervoar die moeilike tydperk dan ook met 'n verdieping in hulle huwelik- en geloofslewe.

Psychonephrology is the study of psychological factors which are evident in end-stage renal disease (ESRD). ESRD is regarded as a life-threatening disease, which shortens the life-expectancy of a patient if he does not receive treatment. ESRD can be divided into three stages: the pre-dialysis, dialysis and transplant stages. These stages are signified by differences in medical treatment methods. None of these leads to a cure but all alle.viate symptoms of the uremic syndrome, increase the life-expectancy of the patient and are supposed to improve his quality of life. Depression and anxiety are general symptoms found in end-stage renal patients. The reasons for this are the patient's psychological reaction to renal disease, dialysis and/or transplant. Patients must also endure the side effects of medical treatment. Adjustment in vocational and social functioning is also evident. ESRD not only has a psycho social impact on the patient but also affects the healthy spouse. This is why most married couples together experience the impact of ESRD in their marital and family life. For optimal adjustment to ESRD couples need to master certain adaptational tasks, such as treating ESRD as a shared problem, adopt the roles of patient and caregiver, manage the various needs of closeness and distance between patient and caregiver and change of career roles, as well as effectively communicating with each other and the medical team, and instrumentally and emotionally support eac~ other in order to maintain the marital bonds. The results of this investigation show that marital variables, such as a decrease in recreation and sexuality and role equality, are important to ease the adjustment to ESRD. It was also found that religion has an important adaptational function for the married couples. A support system of family, friends, other renal patients, the medical team and a psychologist are also important to aid the couples' adjustment. Lastly it should be possible for renal couples to maintain, or even to positively reconstruct their marital relationship, and to experience marital satisfaction in the face of the threat of ESRD. Apparently most couples experience this ordeal as a time of intensification of their married and spiritual life.