الفهرس 
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Abstract
Summary
Haemodialysis is one of two options for treating ESRD;
however, patients undergoing haemodialysis life long program
struggle with multiple life situations, including physical
symptoms such as fatigue, weakness, loss of appetite,
emotional suffering, lack of mental hardiness, social pressures.
These challenges and concerns tend to hinder the patients’
coping abilities and their sense of satisfaction with life in
general, as they become vulnerable to stress and depression,
the threat of death and loss of autonomy and dependency on
medical machine (Arhuidese, et al., 2018).
Coping mechanisms are psychological strategies that a
person uses consciously or unconsciously for overcoming
stressful situations and returning to the normal emotional
situation. Also it can be said that they are an acquired
mechanisms or a person’s responding methods to a stimulus to
cope with a change. Coping with ESRD is critical, as it infl
uences the patients’ ability to manage their lives and adjust to
life demands in a way that enhances their well-being.The
process of coping for patients on haemodialysis treatment
requires great effort from the patients and plenty of support
and involvement from other social systems, such as family and
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156
both formal and informal organizations. This study aimed to
asssess factors affecting coping mechanism among patients
with ESRD on hemodialysis and is based on an alarming trend
of a rapid increase in the number of individuals diagnosed with
the disease (Pasaribu, 2021).
Aim of the Study
This study aimed to assess factors affecting coping
mechanism among patients undergoing hemodialysis life long
program.
Research Question:
The current study was formulated to answer the
following question was developed:
1. What are the factors affecting coping mechanism among
patients undergoing hemodialysis life long program?
Research Design:
A descriptive exploratory research design was utilized to
conduct this study.
Setting:
The current study was conducted at the hemodialysis
unit in Ain Shams University Hospital, which affiliated to Ain
Shams University.
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Subjects:
A purposeful sample of (70) adult patients from both
genders at end stage renal disease and undergoing
hemodialysis program from the above mentioned settings.
Data Collection Tools:
Data were collected through the following tools:
Patients’ interviewing questionnaire (Appendix I ):
It was developed by the researcher and included three parts
as the following:
Part (1): Socio-demographic data: to assess the
characteristics of patients which include (age, gender,
marital status, educational level, smoking, occupation,
monthly income, residence and crowding index).
Part (2): Medical data to assess and collect data about
patient’s medical history based on reviewing of
scientific literature (Polinder, et al., 2018). The
sheet consisted of (12) questions in the form of
multiple choice questions (MCQ). The questions
divided into (2) sections:
Past medical and Family history.
Current medical history.
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Part (3): Patients’ knowledge assessment:
It was used to assess patient’s level of knowledge about
hemodialysis patients long life program. It was developed by
the investigator in simle Arabic language based on reviewing
of scientific literature (Hamza et al., 2021) Fadlalmola&
Elkareem, 2020) and divided into four sections as following:
Section 1: It was concerned with assessment of patients
knowledge regarding dialysis and renal failure.
Section 2: It was concerned with assessment of patients
knowledge regarding complications of dialysis , Laboratory
and diagnostic investigations for renal failure.
Sections 3: It was concerned with assessment of patients
knowledge regarding exercising sporting and regular
investigations.
Section 4: It was concerned with assessment of patients
knowledge regarding smoking and sexual abilities.
Second tool: Concerned with assessment of factors
affecting coping mechanism among patients undergoing
hemodialysis life long program:(Appendix II):
It was used to assess factors affecting coping
mechanism for patients undergoing hemodialysis life long
program. This tool was developed by the investigator in
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159
Arabic language based on recent and relevant literature.it was
composed of (58) questions, dividing into 5 sections:
Section 1: It was concerned with assessment of the social factors
affecting coping mechanism for patients undergoing
hemodialysis life long program.
Section 2: It was concerned with assessment of the economic
factors affecting coping mechanism for patients
undergoing hemodialysis life long program.
Section 3:It was concerned with assessment of the
psychological factors affecting coping mechanism for
patients undergoing hemodialysis life long program.
Section 4: It was concerned with assessment of disease and
therapy related factors affecting coping mechanism for
patients undergoing hemodialysis life long program.
Section 5:It was concerned with assessment of health care
system and providers factors affecting coping mechanism
for patients undergoing hemodialysis life long program.
Third tool: Assessment patients’ level of coping regarding
hemodialysis patients life long program: (Appendix III):
This tool was developed by the investigator in simple
Arabic language after reviewing the related literature (Hamza
et al., 2021) & (Ghaffari et al., 2019) to collect data about
patients and how to cope with hemodialysis. It was composed
of (59) questions, dividing into six sections:
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160
Section 1: it was concerned with assessment of patients’level
of social coping regarding hemodialysis patients life
long program.
Section 2: it was concerned with assessment of patients’level
of psychological coping regarding hemodialysis
patients life long program.
Section 3: it was concerned with assessment of patients’level
of religious coping regarding hemodialysis patients life
long program.
Section 4: it was concerned with assessment of patients’level
of emotional and cognitive coping regarding
hemodialysis patients life long program.
Section 5: it was concerned with assessment of patients’level
of behavioral coping regarding hemodialysis patients
life long program.
Section 6: it was concerned with assessment of patients’level
of therapeutic coping regarding hemodialysis patients
life long program.
Result:
The main findings of the study revealed that:
Regarding socio-demographic data of the studied patients,
37.1% of the studied patient’s age was ≥55 years, 74.3%
were male patient, 34.3% with primary education, 62.9% of
them were married, while 55.7% were not working, and
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161
61.3 % of them their work needs mental efforts and 75.7%
had inadequate income.
Regarding medical data of the studied patients 80% of the
studied patients had chronic diseases, 54.3% of them had
hypertension as a chronic disease while 34.3% had renal
inflammation. 81.4% hadn’t family members suffered from
renal failure while 61.5% of the studied patient’s family
members had hypertension while 74.3% of patients family
members hadn’t hemodialysis.
Regarding total knowledge more than half of the studied
patients had unsatisfactory knowledge regarding to the
disease.
Concerning to total level of coping, majority of the studied
patients had a negative coping with the disease.
There were a statistically significant correlation between
patients’ total level of knowledge and their level of coping
with their disease.
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Conclusion
The results of this study concluded that:
More than half of the studied patients had unsatisfactory
knowledge regarding to the disease. Concerning to total level
of coping, majority of the studied patients had a negative
coping with the disease. Moreover, there is a statistically
significant correlation between patients’ total level of
knowledge and their level of coping with their Recommendations
Based on the current study findings, the following
recommendations are suggested:
The study recommends using press, media and community
gatherings to raise public awareness about renal failure.
Developing health education program for hemodialysis
patients about factors affecting coping mechanism related to
hemodialysis treatment and coping strategies with these
factors,in order to encourage patients to cope effectively in
daily life.
Education and counseling should begin pre-dialysis to help
patients identify existing coping strategies and to develop
new ones.
Furthers researches
Replication of the study on a larger probability sample is
recommended to obtain more generalize data.
Working toward increasing patient awareness and
screening for CKD at regular intervals among high risk
groups is paramount to recognize chronic kidney disease at
early stage before the progresses to kidney failure.
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simple manual or guidelines about how to care for patients
undergoing hemodialysis should be available in all units to
be provided to newly admitted patients.
Develop and coordinate multidisciplinary team approach in
the hemodialysis unit that include the primary nurses, renal
physicians, social workers, dietitians, psychotherapists and
physiotherapists to assist patients in maintaining coping
strategy at the highest possible level