الفهرس 
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Abstract
Summary
Chronic disease are life- long conditions, which may produce a distressing life, people with chronic illness live in a dual world , walking a life line between being well or sick , they deal with different demands and adaptation. Patients having a chronic condition such as ESRD are likely to have an impact on their every day live (Mok & Tam, 2001; Ersoy-Kart & Guldu, 2005).
The present study aimed to:
1- Assess psychological stress related to hemodialysis patients.
2- Identify the coping strategies used by these patients when facing various stressors.
3- Investigate the relationship between these stressors and the coping strategies used by these patients.
Setting:
This study was conducted in El-Minia University hospital at Dialysis Unit. This unit serves El-Minia Governorate & all surrounding areas. The unit divided into two places, one place for hemodialysis patient and other place include one room for peritoneal dialysis .Dialysis unit includes about 45 beds.
Sample:
Convenient sample were selected from Dialysis unit at El-Minia University hospital. The numbers of patients admitted to this unit every month reach about 500 patients. The studied sample included 250 of hemodialysis patients, in the period from January 2010 to July 2010.
The main results yielded by this study were:
1. More than half of the studied samples 55.2% were males. While 44.8% of the studied sample was in the age group that ranged from 20 to 40 years. More than half of the studied sample 59% residing rural areas.
2. In relation to emotional focused coping; more than half of the studied sample 58.4% found that they are satisfied about themselves, while about half of them 50.8% reported that sometimes they fall under stress, fatigue and tension. Also it was founded that more than half 61.2% of the studied sample sometimes feel worried.
3. Concerning problem focused coping; the majority of the studied sample 97.6% suffered from lack of urine output, while 62.8% of them cope with this problem by attention to go to dialysis regularly. More than half of patient 65.2% reported that they had shortness of breathing at sleep time, while 54.8% of them taking a deep breath to get rid of this problem.
4. As regards stress levels among the studied sample; thirty six percent of the patients had moderate level of stress, while 14% of them suffered from severe level of stress and the rest of the sample had normal and or mild stress levels.
5. There was highly significant relation between stress and age, marital status& educational level, (P= 000, .000, .004 respectively). Patients in age group < 20 years, single, free work, and urban patients groups are more susceptible to suffer from severe and extreme stress than other patients.
6. There was highly significant relation between stress as regards duration of dialysis, &frequency of dialysis per week, with (P= .000 & .009 respectively). Patients with duration of dialysis less than 6 months and those maintained on dialysis more than twice per week were more susceptible to suffer from severe and extreme stress than other patients.
7. There was significant relation between age and emotion –focused coping, (P=.004). Also there was significant relation between place of residence and problem- focused coping, (P= .041).
8. There was strong positive significant correlation between self concept, patient relationship, social support and problem focused coping (r = .540, P= .000, r = .337, P= .000, r=.503, P=000, respectively). There was negative significant correlation between patient’s relationship with others, self concept and emotion focused coping
(r = -.274, P=.006, r= -.282, P=.002, respectively).