Abstract
After studying patients’ adaptation to chronic hemodialysis in the late 1960s, Abrami described a series of stages through which a dialysand passed. When entering dialysis the patient was at death’s door and much too numb to care about his future. Apathy was the general attitude in this initial stage. A period of euphoria followed when the patient realized he had “returned from the dead” and was joyous over his fresh start. After a few weeks of dialysis, a state of anxiety developed as the patient became more and more aware of the life-maintaining equipment and procedures. The final stage described by Abram was the struggle for normalcy the patient undertook in coping with his illness.
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