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April 1969

Roles of Denial in Chronic Hemodialysis

Author Affiliations

Durham, NC
From the Division of Psychosomatic Medicine, Department of Psychiatry, Duke University Medical Center, and Veterans Administration Hospital, Durham, NC.

Arch Gen Psychiatry. 1969;20(4):433-437. doi:10.1001/archpsyc.1969.01740160049008

DURING the past decade, hemodialysis has become an established treatment for chronic renal failure. The use of long-term intermittent hemodialysis is now successful in maintaining the lives of individuals who otherwise, in the past, would have succumb to a uremic death. With this procedure, these patients are sustained to return to their home, and assume a more or less usual life.

With the beginning of treatment, two to three times weekly, the dialysand (hemodialysis patient) is initiated to the endless series of accommodations and compromises that are to follow. These not only involve the dialysand, but also significantly affect members of his family and community. The early adjustments may require moving his home closer to the dialysis center, modifying his employment, or changing his responsibilities in the home. These initial modifications may be major changes, but they generally prove to be the least of the many accommodations, that he

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