Abstract
ObjectiveAnxiety is the most frequent emotional reaction to the chronic somatic disease. However, little is known about anxiety and coping strategies in patients with end-stage renal disease (ESRD) undergoing renal replacement therapies (RRTs). The purpose of the study was to assess the intensity and determinants of anxiety in patients treated with different RRTs in comparison with end-stage breast cancer patients and healthy controls.MethodsThe study involved (1) ESRD patients undergoing different RRTs: 32 renal transplant recipients, 31 maintenance haemodialysis and 21 chronic peritoneal dialysis patients, (2) women with end-stage breast cancer (n = 25) and (3) healthy persons (n = 55). We used State–Trait Anxiety Inventory, Scale of Personal Religiousness, Mental Adjustment to Cancer Scale, Rotterdam Symptom Checklist with reference to medical history. The data thus obtained were analysed using the analysis of variance, the Tukey’s HSD post hoc test and Spearman’s rank correlation coefficient.ResultsBoth ESRD and breast cancer patients revealed higher level of anxiety state and trait than healthy controls; however, there was no statistically significant difference found between both findings. There was a tendency towards higher levels of anxiety state in breast cancer patients when compared to ESRD patients undergoing the RRT treatment and for both groups non-constructive coping strategies correlated with the levels of anxiety state. With ESRD patients undergoing RRTs, the intensity of anxiety state did not depend on the mode of treatment but on the correlation between the levels of anxiety and the general quality of their life, psychological condition and social activity.ConclusionIn patients with advanced somatic disease (ESRD and end-stage breast cancer), non-constructive strategies of coping with the disease require further evaluation and possibly psychological support.
Highlights
End-stage renal disease (ESRD) has become a major increasingly prevalent health issue
Majkowicz Department of Research on Quality of Life, Medical University of Gdansk, Gdansk, Poland were analysed using the analysis of variance, the Tukey’s HSD post hoc test and Spearman’s rank correlation coefficient. Both end-stage renal disease (ESRD) and breast cancer patients revealed higher level of anxiety state and trait than healthy controls; there was no statistically significant difference found between both findings
There was a tendency towards higher levels of anxiety state in breast cancer patients when compared to ESRD patients undergoing the renal replacement therapies (RRTs) treatment and for both groups non-constructive coping strategies correlated with the levels of anxiety state
Summary
End-stage renal disease (ESRD) has become a major increasingly prevalent health issue. RRTs prolong the lives of ESRD patients but at the same time bring them an enormous burden. A broad range of physical symptoms, activity limitations, altered body image, fatigue and various treatment-related restrictions are stressors precipitating the need for coping efforts and possibly leading to negative outcomes such as depression and anxiety. Anxiety is an unpleasant emotion affecting patients with advanced somatic disease, and there are various ways of coping with it. Anxiety is a response to either a threatening situation, a risk of losing an important value or a lack of stability, that is, the feeling of insecurity connected with finding oneself in a new unfamiliar situation [5].
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