Abstract
Abstract Background and Aims The start of peritoneal dialysis (PD) in patients affected by end stage renal disease (ESRD) may have a significant psychological impact. Aim of this study was to assess the most frequent reasons triggering the request of psychological referral in patients starting PD. Method A thematic analysis of the clinical diaries of the psychological support sessions of 15 consecutive patients requesting a psychological referral during the first 3 months of PD was performed from 2018 to 2021. Results Fifteen patients were enrolled, 6 women and 9 men. The median age was 59 (range 27–73) and the cause of the ESRD were glomerulonephritis (5/15), diabetic kidney disease (2/15), tubulo-interstitial (2/15), vascular nephropathy (1/15), other (5/15). The most frequent symptoms triggering the request for a psychological referral were insomnia and anxiety respectively in 12 and 15 cases. From the psychological assessments the most frequent causes of the patients’ symptoms have been identified as per follow: - Difficulties in elaborating and accepting the chronic disease (why me?) in 15 Patients.- Difficulties in accepting the esthetical impact of the peritoneal catheter (in the summer how will I do it?) in 15 patients.- The difficulties related to managing fluid restrictions in 15 patients- The limitations to traveling (what if something happens to me?) in 13 patients.- The difficulties to comply to the dietetic restriction (things taste like cardboard; I always eat the same things) in 7 patients.- Difficulties in accepting the dependency to the dialysis (I feel tied to the machine; you can’t do anything) in 6 patients.- The concerns related to the risks of developing peritonitis (fear of not doing the procedure correctly) in 5 patients.- The anxiety of not being able to fulfil the tasks requested by the treatment (I can’t; I lack air when I have to start dialysis) in 6 patients. Conclusion This qualitative study performed in PD patients during the first 3 months of dialysis identified the most frequent causes triggering the request of a psychological referral. These findings may be of help for the physicians in order to identify which aspects need to be better discuss during the pre-dialysis counselling and stresses the importance of the availability of a psychological support in a PD unit.
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