| [ Summary ] |
End-stage renal disease patients reach an acceptance of dialysis therapy by progressing through a process of “denial”, “anger”, “negotiation” and “depression”. Once therapy has been “accepted” and begun, patients are apt to show emotional rebounding faced with the reality of the therapy, and then may enter a depressive state. This is chiefly because there are various factors which cause them anxiety. However, the expression of patients' depressive or anxious states varies widely, depending upon their basic character. The dialysis staff should understand psychological changes in dialysis patients and listen to patients carefully and sympathetically. If necessary, simple self-rating screening depression diagnostic tools such as SDS, BDI and CES-D, which have been reported to be effective for measuring the presence and severity of depressive symptomatology, should be employed and patients referred to a liaison psychiatrist according to the results. It must be kept in mind that the most important points are careful treatment and observation. |