Abstract
Introduction: Ego strength represents an important variable that could be predictable about health and compliance in chronic diseases. In this study we propose a new questionnaire, E.F.E. “Ego Functioning Experience”, able to reveal the psychological functioning profile in Hemodialysis patients. The aim of this work, is to underline the existing relations between emotional profile and compliance, whit E.F.E., that may be predictive of a state of psychologycal health in hemodialysis patients. Methods: Study population included 90 hemodialysis patients. The study protocol was made by three psychological tests: the E.F.E. Questionnaire, the DMI, the Self-Liking and Self-Competence Scale. Results: Factor analysis extracts three factors: 1) “Need of Ego support”; 2) “Ego activity oriented to treatment”; 3) “Ego strength”. The correlation coefficients between the E.F.E. Questionnaire factors (three factors) and other measures, showed a direct correlation with the first factor and “turning against object” TAO of the DMI test (correlation is significant at the 0.001 level) and an inverse relation with set mechanisms of “Principalization”, PRN of the DMI (correlation is significant at the 0.005 level). The correlations of the second and the third factors with other measures, were not statistically significant. No relations were found about other variables. Conclusions: The E.F.E. questionnaire is a simple evaluation to detect hemo-dialysis patients who may need greater attention to the psychological health and therefore the need for treatment such as psychological support. In fact, lower presence of ego strength is indicative of poor compliance to clinical treatment in hemodialysis, but also of worsening of psychiatric symptoms such as demoralization and depressed mood. In conclusion, an increased social support is needed in hemodialysis patient in order to achieve better compliance and achieve a better state of psychological health in chronic hemodialysis patients.
Highlights
Ego strength represents an important variable that could be predictable about health and compliance in chronic diseases
The six tem that failed to load is: “I accept the treatment for my disease”, “I am interested about what happens around me”, “In is easy for me to stay with others”, “I am conscious about my disease”, “I have no-one to call when I have problem”, “I think that dialysis influences my personal situation”
Our data suggest that the first factor can be considered a therapeutic index, as it indicates, with high scores, a clear indication to Ego support, e.g. the presence of cases of depression and other relational problems
Summary
Ego strength represents an important variable that could be predictable about health and compliance in chronic diseases. In patients with Chronic Kidney Disease (CDK) this ability is severely put to the test by the frustration caused by hemodialysis [7] The importance of this problem is reported in literature by studies that documented adaptation problems and specific differences that patients on hemodialysis [8,9,10,11,12]. This adaptation process, is based on the model biopsycho-social, because the CKD is a biological complex disease, in which into play factors clinical and psychosocial, that interact differently with each other, in OPEN ACCESS. Psychosocial factors e.g. the presence of social support, aspects of self-esteem, negative emotion e.g. anger and feelings of discouragement, perception of illness and religion, play an important psychological role in subjects with CKD and may affect the clinical factors and the biological state of this patients [13,14,15,16,17,18]
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