Mental health and quality of life of patient with end-stage kidney failure on hemodialysis treatment

Uvod: Psihonefrologija je nauk, ki obravnava telesno in duševno zdravje pacientov s kronično ledvično odpovedjo. Kronična ledvična odpoved predstavlja zadnjo stopnjo kronične ledvične bolezni in ima škodljiv vpliv na kakovost življenja pacienta, saj vpliva na njegove telesne, duševne in družbene vidike življenja. Pacienti s kronično ledvično odpovedjo se pri izbiri ledvičnega nadomestnega zdravljenja najpogosteje odločijo za hemodializo. Zdravljenje s hemodializo ohranja in izboljša telesni vidik zdravstvenega stanja pacienta, medtem ko vidik duševnega zdravja pacienta ostane manj pomemben ali celo ni obravnavan kot sestavni del procesa zdravstvene nege. Zmanjšana kakovost življenja poslabša stanje duševnega zdravja in poveča tveganje za razvoj duševnih motenj. Pri hemodializnih pacientih se najpogosteje pojavi depresivna ali anksiozna duševna motnja. Duševna motnja, ki ni zdravljena ali pa je zdravljena neprimerno, vodi v življenjsko ogrožajoče samomorilno vedenje pacienta. Zdravljenje duševne motnje pri pacientu, ki se zdravi s hemodializo, še dodatno oteži izvajanje kakovostne zdravstvene nege. Nastanek duševne motnje lahko izvajalci zdravstvene nege preprečijo z odgovornim vrednotenjem kakovosti življenja in duševnega zdravja hemodializnih pacientov. Namen: Namen diplomskega dela je predstaviti in pojasniti spremembe duševnega zdravja, ki lahko ključno vplivajo na potek zdravljenja in kakovost življenja pacientov na hemodializnem zdravljenju. Metode dela: Z opisno metodo dela je bil opravljen pregled domače in tuje znanstvene in strokovne literature. V končni pregled literature je bilo vključeno naključno število primerne literature, ker je bilo število potencialno sprejemljive literature preobsežno. Za prikaz študij je bilo uporabljenih 25 enot literature na temo duševnega zdravja in kakovosti življenja pacientov na hemodializnem zdravljenju. Rezultati: Iz prikazanih študij je razvidno, da so bili za pojav depresije, anksioznosti in zmanjšane kakovosti življenja pri pacientih na hemodializnem zdravljenju, odgovorni mnogi individualni, družbeni in klinični dejavniki. Opazimo močno povezavo med deperesijo, anksioznostjo in zmanjšano kakovostjo življenja pacientov na hemodializnem zdravljenju, kar kaže na to, da lahko vsi trije problemi predstavljajo vzrok ali posledico sprememb v duševnem zdravju ali kakovosti življenja. Deleži razširjenosti omenjenih duševnih motenj se zelo razlikujejo zaradi števila proučevanih pacientov, ocenjevalnih orodij in dejstva, da je izjemno težko v kratkem časovnem obdobju prepoznati duševno motnjo pri teh pacientih. V večini pregledanih študij je možno opaziti spodbudo k vrednotenju in vključevanju duševnega vidika zdravja hemodializnih pacientov v vsakodnevni proces zdravstvene nege. Razprava in zaključek: Zmanjšana kakovost življenja pacienta povzroči spremembe tudi v stanju duševnega zdravja pacienta, zato pri hemodializnemu pacientu ni dovolj samo poskrbeti za telesni vidik obravnave, saj je duševni vidik obravnave enako pomemben dejavnik učinkovitosti hemodializnega zdravljenja. Popolno obvladovanje sprememb duševnega zdravja in kakovosti življenja hemodializnih pacientov je težko izvdeljivo v praksi zdravstvene nege, saj se psihonefrologiji trenutno posveča premalo pozornosti. Odgovornost za pacientovo duševno zdravje in kakovost življenja je enakomerno porazdeljena med pacientom in izvajalci zdravstvene nege, zato je pomembno obojestransko sodelovanje, zaupanje in spoštovanje za zagotovitev optimalne kakovosti zdravstvene nege hemodializnega pacienta.Introduction: Psychonephrology is the science that deals with the physical and mental health of patients with chronic kidney failure. Chronic kidney failure is the final stage of chronic kidney disease and has a detrimental impact on a patient\u27s quality of life, affecting physical, mental and social aspects of life. Patients with chronic kidney failure most often opt for haemodialysis when choosing renal replacement therapy. Haemodialysis treatment maintains and improves the physical aspect of the patient\u27s health, while the mental aspect of the patient\u27s health remains less important or is not even considered as an integral part of the care process. Reduced quality of life worsens mental health and increases the risk of developing mental disorders. Depressive or anxiety disorders are most common in haemodialysis patients. A mental disorder that is left untreated or inadequately treated leads to life-threatening suicidal behaviour. Treating a mental disorder in a patient undergoing haemodialysis further complicates the delivery of quality care. Care providers can prevent the onset of mental health problems by responsibly assessing the quality of life and mental health of haemodialysis patients. Purpose: The aim of this diploma work is to present and explain the mental health changes that can have a crucial impact on the course of treatment and quality of life of patients undergoing haemodialysis treatment. Methods: A descriptive method was used to review the domestic and foreign scientific and professional literature. A random number of relevant literature was included in the final literature review because the number of potentially acceptable literature was too large. 25 units of literature were used to review studies on mental health and quality of life in haemodialysis patients. Results: The studies presented here show that many individual, social and clinical factors were responsible for the occurrence of depression, anxiety and reduced quality of life in haemodialysis patients. There is a strong association between depression, anxiety and reduced quality of life in haemodialysis patients, suggesting that all three problems may be a cause or consequence of changes in mental health or quality of life. The prevalence rates of these mental disorders vary widely due to the number of patients studied, the assessment tools used and the fact that it is extremely difficult to identify a mental disorder in these patients in a short period of time. In most of the studies reviewed, there is a push to evaluate and integrate the mental health of haemodialysis patients into the daily nursing process. Discussion and conclusion: The reduced quality of life of the patient also leads to changes in the patient\u27s mental health, so it is not enough to care for the physical aspect of the haemodialysis patient\u27s care, as the mental aspect of the care is an equally important factor in the effectiveness of the haemodialysis treatment. Full management of changes in mental health and quality of life in haemodialysis patients is difficult to implement in nursing practice, as psychonephrology is currently under-researched. The responsibility for the patient\u27s mental health and quality of life is shared equally between the patient and the care providers, so mutual cooperation, trust and respect are important to ensure optimal quality of care for the haemodialysis patient