Schneider M S, Friend R, Whitaker P, Wadhwa N K
Department of Psychology, State University of New York, Stony Brook, 11794-2500.
Health Psychol. 1991;10(3):209-15. doi: 10.1037//0278-6133.10.3.209.
Fluid noncompliance in patients with end-stage renal disease (ESRD) is a widespread problem with severe consequences for health. In addition, ESRD patients report considerable stress in relation to their illness and dialysis treatment. The present study examined the role of cognitive and emotional variables in fluid noncompliance, symptomatology, and stress. Fifty hemodialysis patients were assessed (a) on the cognitive variables of locus of control, self-evaluations of their past compliance, and self-efficacy to resist fluid intake and (b) on the emotional variables of depression, anger, and anxiety. Results showed that cognitive variables accounted for fluid noncompliance and predicted future adherence. Patients high in negative emotions complied equally as well as patients low in negative emotions but were found to report substantially more symptomatology and distress associated with their treatment. The implications of these findings for treatment of ESRD patients and future research are discussed.
终末期肾病（ESRD）患者的液体不依从是一个普遍存在的问题，对健康有严重影响。此外，ESRD患者报告称在疾病和透析治疗方面承受着相当大的压力。本研究考察了认知和情绪变量在液体不依从、症状表现及压力方面所起的作用。对50名血液透析患者进行了评估：（a）评估其控制源、对过去依从情况的自我评估以及抵制液体摄入的自我效能等认知变量；（b）评估其抑郁、愤怒和焦虑等情绪变量。结果显示，认知变量可解释液体不依从情况并能预测未来的依从性。消极情绪高的患者与消极情绪低的患者依从性相当，但发现前者报告的与治疗相关的症状表现和痛苦要多得多。文中讨论了这些研究结果对ESRD患者治疗及未来研究的启示。
