The experience of uncertainty among patients having peritoneal dialysis

Title. The experience of uncertainty among patients having peritoneal dialysis. Aim. This paper is a report of a study conducted to examine factors (severity and duration of the disease, credible authority, social support, education) that may influence the level of uncertainty and stress in patients having peritoneal dialysis. Background. Although home peritoneal dialysis improves the patient's quality of life, it has both physiological and psychosocial disadvantages. These disadvantages, along with the experience of chronic disease (end-stage renal disease), create strong feelings of stress and uncertainty. Few studies have examined the correlation between the peritoneal dialysis experience and this level of uncertainty. Method. The sample comprised 71 patients having peritoneal dialysis. Their average age was 57 years (SD = 12·8), average number of years of education was 11·9 (SD = 3·25), and average time on peritoneal dialysis was 30·6 months (SD = 12·8). Data were collected from February to June 2004; the subjects answered a questionnaire comprising medical data, perception of the nurse and/or physician as epistemic authority, satisfaction with social support, level of uncertainty regarding the disease, its treatment and outcomes, and level of stress. Findings. Only patients' self-rated health and level of education, and doctors' epistemic authority contributed statistically significantly to explaining patients' uncertainty. Level of education was found to affect both uncertainty and stress. The factors that most influenced patients' uncertainty were related to their ability to process information. Familiarity with their disease was less influential. Conclusion. Peritoneal dialysis nurses should be aware of the fact that they can reduce their patients' uncertainty and stress by helping them to maintain hope and to view their health status positively.