Saturday, July 24, 2004
This presentation is part of : Chronic-Illness Management
Illness Representations and Activity Self-Regulation of Elders With End-Stage Renal Disease (ESRD)
Charlotte Thomas-Hawkins, PhD, RN, CNN, College of Nursing, College of Nursing, Rutgers, The State University of New Jersey, Newark, NJ, USA
Learning Objective #1: Describe the domains of the Common-Sense Model of Self-Regulation of Health and Illness
Learning Objective #2: Discuss the illness representation of elderly individuals with end-stage renal disease who are receiving chronic hemodialysis treatments

Elderly individuals with ESRD are at high risk for poor functional outcomes. Investigations of functioning in elderly ESRD patients have ignored how these patients represent their illness, that is, their beliefs and perceptions as to how ESRD affects their bodies and ongoing function. These representations may affect the strategies that elderly hemodialysis patients adopt in managing their illness and regulating their everyday activities. The purpose of this study was to explore elderly hemodialysis patients’ representations of ESRD, its symptoms, and the implications of their representations for self-regulation of daily activity. Leventhal's Common Sense Model guided this study.

A qualitative content analysis method was used. The sample consisted of 10 women and 14 men who were receiving chronic hemodialysis. Participant's ages ranged from 65 years to 89 years.

Study findings indicate that many elders lack clear representations of ESRD or its symptoms. While most participants identified similar symptom experiences, many were not able to identify causes for their symptoms. Moreover, while most participants viewed ESRD as long-term and serious, they did not feel that their symptoms were serious or cause for concern. Furthermore, most participants were not worried about their illness or their symptoms. In fact, many participants indicated that they did not report symptoms to the doctor or nurse, but chose to discuss their symptom experiences with "lay consultants". Many participants adopted an activity strategy of energy conservation in response to their symptoms, while others adopted a “use-it-or-lose-it” activity strategy.

In conclusion, these findings suggest that elderly hemodialysis patients lack coherent representations of ESRD and its symptoms. While more research is needed in this area, the findings also suggest that educational and symptom management interventions that are tailored to elderly dialysis patients’ representations of their illness and symptoms may prove helpful in increasing their level of participation in daily activities

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Sigma Theta Tau International
July 22-24, 2004