| Summary: | 碩士 === 南華大學 === 生死學研究所 === 89 === Abstract
The purpose of this study is to explore how hemodialysis patients live with their illness given the permeating death anxiety they experience in and out of the hemodialysis treatment process. Based on the literature and the finding of a pilot study, the current study untangles this complex issue by explore the following questions: (1). How do these patients adapt to their illness and the treatment? (2). How does their social support change as time goes by? (3). How do their death attitudes and life goals change over time?
Prior related studies are mainly quantitative in nature and deal with measurable variables like stressors and stress levels. The questions raised in this study are broad and exploratory in nature, so qualitative methods are a more suitable tool. Being a certified hemodialysis nurse working in the hemodialysis unit, the researcher has the privilege to approach these patients, build up rapport with them, and invite them to participate in this study. The research interviewed a total of nine patients. In-depth semi-structural interviewing was employed to collect data and grounded theory method was used to analyze data and guide the subsequent data collecting.
The findings show that the process of patients’ adapting to the illness can be classified in to six stages, namely, alertness, procrastination and avoidance, depression, making comparisons, acceptance of hemodialysis as a part of one’s own life, and finding out the best personal surviving method. Their social support did undergo changes as the illness prolonged and the treatment continued over time. And the change took different forms. Under the incessant treat of death, these patients’ death attitudes were also undergoing changes. Among these nine participants, they all achieved the stages of accepting their fate and were prepared to face their death without fear. With regard to their life goals, the married patients were devoted to caring for their offspring while the single ones were concerned about their own self-actualization.
The finding were compared to the death anxiety model proposed by Tomer & Eliason (1996) and further discussed in terms of Erikson’s psychosocial developdmental theory. It is concluded that the death attitudes and the life goals these patients developed enabled them to fight against death anxiety. Together with social support, the three factors enabled the patients to live on hope. Based on the findings, a provisional theory is proposed. Some suggestions are made for further research and clinical care.
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