Dialysis-dependency: The reformulated or remnant person
Kristine Martin-McDonald
Department of Nursing, University of Southern Queensland, QLD
PP: 151 - 160
Abstract
Being dependent on dialysis is a potentially overwhelming experience where life as previously known is permanently altered. A dialysis-dependent individual may reformulate their identify or perceive that they are a remnant of their former self.
This paper will explore and expand Morse and Penrod's (1999) model as a useful way to understand how a person might reconstruct their identify. Grounded in a narrative methodology, interviews of those on haemodialysis and peritoneal dialysis were thematically analysed.
It was found that dialysis dependency brings an acknowledgment of a lost past, an inescapable present and an unknowable future, filtered through hope and despair. Nurses need to understand the suffering, wrought by such a struggle, to facilitate the positive re-envisioning of those who are dialysis dependent.
Keywords
dialysis; suffering; hope; chronic disease
References
Baumeister, R, Newman, L (1994) How stories make sense of personal experiences: Motives that shape autobiographical narratives. Journal of Personality and Social Psychology, 20(6): 676-690.
Benet, A (1996) A portrait of chronic illness. American Behavioral Scientist, 39(6): 767-777.
Berger, A (1997) Narratives in Popular Culture, Media, and Everyday Life. Sage Publications, Thousand Oaks.
Bruner, J (1986) Actual Minds, Possible Worlds. Harvard University Press, Cambridge.
Caress, A, Luker, KA, Owens, RG (2001) A descriptive study of meaning of illness in chronic renal disease. Journal of Advanced Nursing, 33: 716-727.
Carter, B (1994) Surviving breast cancer. Cancer Practice, 2: 135-140.
Charmaz, K (1991) Good Days, Bad Days: The Self in Chronic Illness and Time. Rutgers University Press, New Brunswick.
Charmaz, K (1999) Stories of suffering: Subjective tales and research narratives. Qualitative Health Research, 9(3): 362-382.
Coyne, I (1997) Sampling in qualitative research, purposeful and theoretical sampling: Emerging or clear boundaries? Journal of Advanced Nursing, 26: 623-630.
Dewar, A, Morse, J (1995) Unbearable incidents: Failure to endure the experience of illness. Journal of Advanced Nursing, 22: 957-964.
Emden, C (1998) Conducting a narrative analysis. Collegian, 5: 34-39.
Emden, C, Sandelowski, M (1999) The good, the bad and the relative, part two: Goodness and the criterion problem in qualitative research. International Journal of Nursing Practice, 5: 2-7.
Ferrans, C, Powers, M (1993) Quality of life of hemodialysis patients. ANNA Journal, 20: 575-581.
Fletcher, A (1999) The place of despair and hope. Social Research, 66(2): 521-530.
Frank, A (1995) The Wounded Storyteller: Body, Illness and Ethics. University of Chicago Press, Chicago.
Hagren, B, Pettersen, I, Severinsson, E, Lützén, K, Clyne, N (2001) The haemodialysis machine as a lifetime: Experiences of suffering from end-stage renal disease. Journal of Advanced Nursing, 34: 196-202.
Janes, G (1990) A better life than before: Quality of life in people with renal failure. Nephrology, October: 226-28.
Kylmä, J, Vehviläinen-Julkunen, K (1997) Hope in nursing research: A meta-analysis of the ontological and epistemological foundations of research on hope. Journal of Advanced Nursing, 25: 364-371.
Kylmä, J, Vehviläinen-Julkunen, K, Lähdevirta, J (2001) Hope, despair and hopelessness in living with HIV/AIDS: A grounded theory study. Journal of Advanced Nursing, 33(6): 764-775.
Lazarus, R (1999) Hope: An emotion and a vital coping resource against despair. Social Research, 66(2): 653-678.
Marshall, C, Rossman, G (1989) Designing Qualitative Research. Sage Publications, Newbury Park.
Martin-McDonald, K (1999) Once upon a time...: Narratives and research. Contemporary Nurse, 8(1): 221-226.
Molzahn, A (1991) The reported quality of life of selected home haemodialysis patients. ANNA Journal, 18: 173-181,194.
Morse, J (1997) Responding to threats to integrity of self. Advances in Nursing Science, 19(4): 21-36.
Morse, J (1989) Strategies for Sampling. In Morse J (ed) Qualitative Nursing Research: A Contemporary Dialogue. Aspen Publishers, Inc., Maryland: 117-131.
Morse, J, Carter, B (1995) Strategies of enduring and the suffering of loss: Modes of comfort used by a resilient survivor. Holistic Nursing Practice, 9: 38-52.
Morse, J, Penrod, J (1999) Linking concepts of enduring, uncertainty, suffering and hope. Image: Journal of Nursing Scholarship, 31: 145-150.
Nesse, R (1999) The evolution of hope and despair. Social Research, 66(2): 429-470.
Polkinghorne, D (1988) Narrative Knowing and the Human Sciences, State University of New York, New York.
Rittman, M, Northsea, C, Hausauer, N, Creen, C, Swanson, L (1993) Living with renal failure. ANNA Journal, 20: 327-332.
Smith, J (1990) Alternative Research Paradigms and the Problem of Criteria. In Guba, E (ed) The Paradigm Logic, Sage Publications, Newbury Park: 167-187.
Stuhlmiller, C, Thorsen, R (1997) Narrative picturing: A new strategy for qualitative data collection. Qualitative Health Research, 7(1): 140-149.
Wolcott, D (1990) Psychosocial Adaptation of Chronic Dialysis Patients. In Nissenson, A, Fine, R, Gentile, D (eds) Clinical Dialysis, 2nd edn, Appleton & Lange, Norwalk: 735-744.

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