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The usage of psychosocial services in hemodialysis centres
HACKLOVÁ, Lucie
Chronic disorder of kidneys is a gradual progression from the state of health to the state of a disease, resulting in permanent failure of excretory, regulatory, and hormonal (metabolic) functions of kidneys. During a kidney failure water and electrolyte imbalance, retention of catabolites, and metabolic acidosis occur; there is a shortage of substances produced in kidneys. A complex metabolic disorder occurs, whose clinic corelate is a uremic syndrom. Conservative treatment consists in adjusting or positive influencing of metabolic deviations through a diet and medication. However, if the conservative treatment is insufficient, it is necessary to proceed to some of the blood purifying methods {--} hemodialysis, peritoneal dialysis. These methods are then followed by kidney transplant. Dialysed people have an abnormal life, as a vitally important organ of theirs does not work and is replaced by an apparatus. Patients are faced with many stresses and bans {--} they have to be on a diet with liquid restrictions, they have to take remedies regularly, due to dialysis days they are time limited, their appearance is often changed, they suffer from sexual disfunction, their sickness rate is high, etc. A successful transplant is a great white hope for the patients, but it also has its medical contraindications, therefore it does not concern all the dialysed patients. Thus a big occurence of depressions and suicides among patients cannot be a surprise. Besides medical care it is then necessary to focus on psychological care and social recovery. However, the results of a questionnaire research did not prove the occurence of psychological problems among the clients of dialysis centres. It proved true that the clients of centres are not interested in using psychosocial services, which was the third hypothesis.Further it came out that the clients are not well informed about social services and social benefits. Thus the second hypothesis was confirmed {--} The clients of centres do not know psychosocial services. The first hypothesis {--} Psychosocial workers are not used by hemodialysis centres {--} was also confirmed. The teams of the centres miss a psychologist absolultely and only one centre has a social worker.
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