Aspetti psicologici e strategie di coping nella dialisi e nel trapianto renale

Aim. Although with different results, dialysis and kidney transplantation represent two effective strategies in treating chronic uraemia. Our study compares the psychological aspects of two categories of patients: on one hand those who faced kidney transplantation and have been in dialysis, on the other hand the non complaint patients treated with these therapies. Methods. We used a test for the analysis of the personality (MMPI2) and the COPE, that tests the abilities to coping used by the patient in certain conditions that can be perceived us stressful or, in any case, as unusual. With both MMPI2 and COPE we tested 120 patients that have faced haemodialysis and 50 that have been subject to peritoneal dialysis. The screening succeeded in 11 cases among the first group and in 9 as far as what concerns the second. 3 of 20 patients are considered partially non complaint. One is subject to peritoneal dialysis the other two to haemodialysis. As far as what concerns the patients that have been subject to kidney transplantation we tested a control group of 300 people with different age, sex, social and cultural status, date and kind of transplantation (either by dead or alive donor). Of the 36 feedbacks received only 30 are considered valuable. Results. The results of the research show that patients with less than two years of dialitic treatment and patients with more than two years survival from transplantation time are inclined to deny their disease and the possible emotions about their clinical status, drawing a non adequate attention to the difficulties. This behaviour is clearer in non complaint patients. Malaise in family and in couple every-day life can push more and more these patients to be non complaint with therapeutic prescription, as they do not feel to be supported adequately. The result is an excess of their foreboding, their disposition and their nervousness. Conclusions. We think that a screening of the patients' social and psychological status is useful as well as a psychological intervention to uraemics who miss an emotional support from the family. This psychological support is advisable for the uraemics that have to enter in a waiting list and for those who are subject to a post operation treatment, in order to promote in both cases complaint behaviour