Psychological aspects of dialysis: does cognitive appraisal determine the overall outcome?

Psycho logical aspects of renal replacement therapy have been studied by numerous researchers. However, many of these studies are of poor quality, involve small study groups, or focus only on a narrowly defined hypothesis. Due to a lack of general conceptual framework, it is difficult to generalize and inter pret the data, especially in terms of the cause-and-effect relationship. Further research is required to assess how patients with end-stage renal disease cope with dialysis-related stress. Particular emphasis should be placed on the preparation of experimental studies and clinical trials with a longer follow-up.