# Psychological Stressor Of End Stage Chronic Kidney Disease Patients On Dialysis. A Battle For Life

## TL;DR

This study explores the psychological challenges faced by chronic kidney disease patients on dialysis, highlighting mood disorders, existential crises, and the impact of social support.

## Contribution

The study identifies novel multi-level factors influencing psychological stress in dialysis patients, suggesting therapeutic interventions.

## Key findings

- Patients experience clinical mood disorders without adequate treatment during dialysis.
- Low social support and adverse events increase the risk of poor outcomes in dialysis patients.
- Misinterpreting dialysis as the end of life worsens mood disorder symptoms and quality of life.

## Abstract

Patients with chronic kidney disease (CKD) may choose to undergo dialysis. Factors that may have led patients to prescribe psychological interventions related to dialysis are poorly understood in the literature. The purpose of this study was to explore multi-level factors surrounding dialysis modalities such as Diagnosed Mood Disorders, Existential crises, Triggering events, Social support, and Distrust towards the process of dialysis.

The study aims to investigate the psychological battle of the client while going through the process of dialysis. The study reveals multiple mood disorders and existential crises leading to depression among chronic kidney disease patients. Therefore the study was conducted with the aim of providing a therapeutic guide line in future once the factors are investigated in detail.

Semi-structured qualitative interviews were conducted in a dialysis clinic in Karachi where 19 participants participated in this qualitative study. The age ranges from 40-76. Initiating with informed consent followed by surveys assessing demographic and clinical information were administered to participants following their interviews.

Qualitative findings suggested that patients were dealing with Clinical Mood Disorders without being provided treatment. Moreover, the cohesive family support enabled them to continue with daily living activities; however, the patients with low support triggering adverse events in life lost their lives in follow-up sessions. Furthermore, nephrology care doesn’t seem sufficient as they are dealing with existential crises of hopelessness, regret, condemnation, and elevated death anxiety. In CKD the misinterpretation of dialysis by cognitively substituting it as End of life increased the clinical symptoms of Mood disorders. Thus the risk factors increase disturbing the quality of life.

Findings point to broader factors affecting dialysis modalities with Mood disorders. The low social support and adverse triggering events precipitate the risk factors of dialysis treatment. Furthermore, distrust towards dialysis and existential crisis are recommended for therapeutic interventions

None Declared