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Dissertation
Stress, coping, and psychological distress: an examination into the experience of individuals utilizing dialysis for end-stage renal disease
Doctor of Philosophy (Ph.D.), Drexel University
May 2008
DOI:
https://doi.org/10.17918/etd-2826
Abstract
End-Stage Renal Disease (ESRD) is a disorder of kidney failure that afflicts over 300,000 individuals in the U.S., and is fatal if left untreated. The most common medical treatment for ESRD is hemodialysis (HD), where metabolic wastes are removed, via a dialysis machine, three times a week, several hours at a time. In addition to the comorbid medical problems and direct physical effects of ESRD, HD often yields a number of dialysis-specific stressors (e.g. fluid restrictions, monotonous dialysis routine, limitations on one's ability to work). Compared to the general population, individuals on HD treatment have elevated symptoms of anxiety, depression, and life dissatisfaction. Extant research has established a robust correlation between dialysis specific-stressors and psychological distress for individuals on HD. Additionally, approach-oriented coping strategies appear to moderate the relationship between dialysis-specific stressors and psychological distress. However, no known previous HD studies have explored the moderating role of social problem-solving, which conceptualizes that effectively coping with life stressors involves the use of both emotional and problem-focused coping strategies in how a person approaches a problem (problem orientation) and how they systematically attempt to address the problem situation (problem-solving style). Social problem-solving has been demonstrated to be a significant buffering agent between life stressors and psychological distress in other populations. This study examined the moderational role of social problem-solving in a diverse sample of 54 adults receiving hemodialysis. Multiple hierarchical regression analyses examined whether specific social problem-solving scales significantly moderated the relationship between dialysis-specific stressors and three types of psychological distress (e.g. depression, anxiety, and life dissatisfaction), controlling for participant demographic factors, disease severity, and negative life events. Avoidance Problem-Solving Style was a statistically-significant moderating variable between HD stressors and depressive symptoms: Negative Problem Orientation trended towards moderation for both anxiety and depressive symptoms. The findings of this study suggest further exploration into the role of social problem-solving coping, as well as the effectiveness of Problem Solving Therapy, for individuals living with hemodialysis.
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Details
- Title
- Stress, coping, and psychological distress
- Creators
- Travis Andrew Cos - DU
- Contributors
- Christine M. Nezu (Advisor) - Drexel University (1970-)
- Awarding Institution
- Drexel University
- Degree Awarded
- Doctor of Philosophy (Ph.D.)
- Publisher
- Drexel University; Philadelphia, Pennsylvania
- Resource Type
- Dissertation
- Language
- English
- Academic Unit
- Psychological and Brain Sciences (Psychology); College of Arts and Sciences; Drexel University
- Other Identifier
- 2826; 991014632542204721