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End-Stage Renal Disease and Psychological Trauma: Shame and Guilt in Hemodialysis Patients, Transplantation Recipient and Donor Candidates, and Controls

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Author(s): Nilgün | Gamze

Journal: Nöropsikiyatri Arşivi
ISSN 1300-0667

Volume: 46;
Issue: 4;
Start page: 249;
Date: 2011;
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Keywords: ESRD | shame | guilt | hemodialysis | transplantation

ABSTRACT
Ob­jec­ti­ve: Psychological trauma can be coupled with a broad range of affects, including shame and guilt. We considered end-stage renal disease (ESRD) as a psychological trauma and assessed whether the experience of shame and guilt have negative effect on mood and health-related quality of life (HRQOL) in hemodialysis patients, transplantation recipient and living donor candidates. Met­hods: The Beck Depression Inventory, Beck Anxiety Inventory, 12-item General Health Questionnaire and the Guilt and Shame Inventory were administered to all participants. The hemodialysis group consisted of 56 individuals, the recipient candidate group - 66 individuals, and the donor candidate and the control groups consisted of 41 and 51 healthy individuals, respectively.Re­sults: Although neither guilt nor shame scores reached a significant value in the hemodialysis, recipient and donor candidate groups, hemodialysis patients had the highest depression, anxiety and HRQOL scores. Conc­lu­si­on: We conclude that the overwhelming majority of renal transplant candidates evince a healthy psychological response to the pre-transplantation waiting period. Our findings also suggest that kidney donor candidates do not experience the pre-transplantation period as traumatic, sustained by the boost in their sense of well-being. We also conclude that hemodialysis patients are the most negatively affected group, although neither guilt nor shame was detected significantly. Further investigation of the trauma-related emotions in ESRD patients, taking treatment-specific differences into account, represents a promising area of future research. (Arc­hi­ves of Neu­ropsy­chi­atry 2011;48: 249-54)
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