Life on dialysis and its effects on meaning-making in people's lives

This collective case study of three men, from a pastoral care perspective, looks at how people change their meaning making and sources of support they find useful as they begin life on hemodialysis. Meaning making, a spiritual process, involves appraising the significance of ourselves and our lives in changing circumstances. The stresses of beginning dialysis may lead to altered meanings. Processes and themes in the subjects' narratives are compared to those from accounts by two more experienced dialysis patients. The new patients regarded this stage in their lives as temporary; the more experienced men had come to greater acceptance. Themes identified included illness cognitions, body images, changing relationships with families and others, the tension between dependence and autonomy, and optimism versus pessimism. The role of the men in determining who they wished to be in the circumstances was noted. Suggestions for further research and for pastoral support are provided