End-Stage Renal Failure & Rehabilitation Rehabilitation of patien

The World Health Organization (WHO) has defined health as "a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity (Kutner, 1994, p. 321)." This general definition has served to delineate certain health care objectives for the chronic diseases. Traditionally, health care providers focused on the clinical aspects of an individual's disease. The WHO's definition of health, however, suggests that caregivers should broaden their emphasis (Levinsky & Mesler, 1994, p. 244).

The pathologic processes of end-stage renal disease (ESRD) follow an evolving course. In adults, ESRD tends to be caused by multisystem disease, diabetes, and hypertension; whereas, in children, ESRD is typically related to congenital problems and "child-oriented" diseases such as renal tumors and the hemolytic-uremic syndrome. Symptoms of renal failure may span the range from being nonexistent to those associated with advanced uremia (Morrin, 1983, p. 1). Generally though, ESR

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o function normally. The depressed person may be unable to work, sleep, eat, or enjoy sexual behaviors. With less severe depression, although symptoms may not disable, they generally prevent the sufferer from functioning optimally (NIMH, b., pp. 1-9). Thirdly, a less prevalent type of depression is known as manic-depressive illness, or bipolar depression. This condition involves cycles of depression and elation. Depression may also be associated with panic disorder. Panic disorder is a potentially disabling psychological condition associated with feelings of terror or anxiety (NIMH, 1991, a.). Other psychological problems common to renal patients include fear of the unknown, fear of death, lack of comprehension of the disease process, and both patient and family denial of the disease process (Anderson & Levine, 1983, pp. 28-29). Yet another aspect of end-stage renal disease involves its vocational effects. Although early studies documented substantial rehabilitation (i.e., employment, active education, or activities as chief houseperson) rates, more recent reports have been somewhat less encouraging. It has been found, for example, that only 23% to 60% of dialysis populations are capable of physical activity beyond the l
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Approximate Word count = 3122
Approximate Pages = 12 (250 words per page)

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