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The purpose of this study was to explore how illness perceptions, specifically intrusiveness, impart individuals with chronic kidney disease living with dialysis therapy and kidney transplants, and to determine the relationships among illness perceptions, symptoms, coping, and quality of life (QoL). Forty-two individuals on dialysis and with renal transplants completed an online survey. We found strong relationships between illness intrusiveness, symptom scores, and QoL. Illness intrusiveness was highly disruptive to one's financial situation, health, and work. Intrusiveness was also significantly related to individual symptoms, especially tiredness, feelings of well-being, and sleep. Correlations between intrusiveness and QoL were significant. Emotion-focused coping strategies were also significantly associated with intrusiveness. Health professionals can target illness perceptions, symptom burden, and coping strategies to enhance QoL.
Key Words: Illness perceptions, intrusiveness, cognitions, symptoms, coping, quality of life, chronic kidney disease, kidney transplantation, dialysis.
Cognitive-perceptual factors play a central role in understanding quality of life (QoL), coping, and health-related behavior among those who are chronically ill. Devins and his colleagues (1983-1984) introduced the concept of "illness intrusiveness" more than four and a half decades ago. Illness intrusiveness refers to the disruption of lifestyles, activities, and interests, attributable to constraints imposed by the illness and its treatment (Devins et al., 1983-1984).
Illness intrusiveness is a psychological construct that encompasses diverse areas, such as disease-related anatomical changes, functional losses, treatment side effects, and diseaseand/or treatment-related lifestyle disruptions (Devins, 2010). It is hypothesized that illness intrusiveness influences psychological well-being and QoL in chronic illness through two complementary pathways (Devins, 2010; Devins, Edworthy, Guthrie, & Martin, 1992; Devins, Edworthy, Paul, Mandin et al., 1993; Devins, Stam, & Koopmans, 1994). One involves the direct reduction of positively reinforcing experiences as a result of decreased involvement in valued activities. The second mechanism involves perceptions of reduced personal control that, in turn, further limit the individual's ability to obtain value and/or avoid negative experiences (Devins, 2010). The aim of this study was to explore the frequency of perceptions of illness intrusiveness among individuals with chronic kidney disease (CKD) living with dialysis therapy and kidney transplants, and to determine how illness intrusiveness is related to symptoms, coping strategies, and QoL.
Literature Review
Perceptions of illness burden influence QoL, self-management, and treatment among individuals on dialysis and with kidney...