Stressors and coping of in-hospital haemodialysis patients aged 65 years and over.

Aims: This paper reports a study to identify the types of stressors experienced by in-hospital haemodialysis patients aged 65 years and older, and the use and perceived helpfulness of coping strategies to manage these stressors.

Background: Chronic renal failure and its treatments impose a variety of physical and psychosocial stressors, which challenge patients. Although the stressors and coping strategies of patients having dialysis treatment have been investigated, no study has specifically focused on older adults. Such investigation is important as the incidence of chronic kidney disease is increasing in this age group.

Method: In this descriptive, correlational study, the Haemodialysis Stressor Scale and Jalowiec Coping Scale were used to investigate stressors and coping strategies reported by 50 in-hospital haemodialysis patients aged 65 years and older. The data were collected in Canada in 2004.

Results: Similar to previous research, the stressors of fatigue and fluid restrictions ranked highly as stressors in this sample. However, interference with social and recreational activities were stressors unique to this group. Findings challenge some common beliefs about haemodialysis patients. It is commonly believed that these patients 'get used to' haemodialysis, and therefore the number and troublesomeness of stressors decrease over time. This belief was not supported because length of time on haemodialysis did not affect participants' appraisal of stressors. Another major finding was that older participants in this sample reported the use of fewer coping strategies and found them less helpful.

Conclusion: Further research is needed to investigate factors affecting the stressors and coping responses of older haemodialysis patients and to determine their impact on health outcomes. Such knowledge will assist nurses in developing age-appropriate strategies for promoting optimum wellness for these patients who will likely spend the remainder of their life adhering to the regimen of haemodialysis.