Study to develop mental health nursing strategy for hemodialysis outpatients

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The purpose of the study is to clarify the psychology of dialysis outpatients and to develop a tool which assesses their psychology so that nurses can use it. We employed cross-sectional research (accidental sampling) using a mail-in questionnaire and continuous interviews with 19 respondents.The response rate was 44.1%, with 608 valid responses. We conducted NEO-Five Factor Inventory test (NEO-FFI Japanese Version by Shimonaka et al. in 1998), asking about age, sex, length of dialysis period, and presence or absence of complications. The result showed that the hemodialysis patients' mean "neurotic tendency" value was within the normal range, contradicting that hemodialysis patients tend to display depressive tendencies. The factors that increase the "neuroticism" were worsening medical conditions, inadequate family compassion, and inconvenient hospital access. The hemodialysis patients' "openness" was lower than for standard adults. The "neuroticism" and "openness" were significantly … More lower for patients aged 65 or over, which contradicts that elderly patients are more likely to have depression.The patients were divided by Cluster Analysis into the following three types, which we named "Agreeable type" (27.0%), "Neurotic type" (38.8%), "Balanced type" (34.1%). Many of the 65+ hemodialysis patients were the "Agreeable type" ; few of them were the "Balanced type."When conducting continuous interviews with 19 respondents, we used "General Mental Health Questionnaire (GHQ28 Japanese Version)" and "Profile of Mood States (POMS Japanese Version)," plus "NEO-FFI" (first time only). The interview survey demonstrated that the patients also include "Introversive type," which have low "extroversion" and "openness", besides the three types above. In addition, the interview data enabled us to classify patients by how they cope with their disease, which allowed concrete descriptions of the four types. We believe the two methods combined could be complementary. We will use these results to develop assessment tools. Less