The impact of dialysis-requiring kidney disease on family quality of life: A descriptive study

BACKGROUND: The alarming increase in prevalence of dialysis-requiring kidney disease is a major health concern in the country. With more patients undergoing dialysis, more families are also exposed to the stresses of caregiving. The aim of this study was to investigate the impact of dialysis-requiring kidney disease on the quality of life of the patient's family. Information on the magnitude and areas of impact is essential in developing strategies to support the family.METHODS: Data were obtained from pre-tested, structured, close ended questionnaires completed by 60 family members of kidney disease patients on dialysis at Holy Child Hospital from October 16 to November 30, 2015. Analysis was carried out using the GNU PSPP software.RESULTS: Most family members were female (77%), the spouse of the patient (34%) or the child (30%), and living with the patient (70%). Eighty-nine percent were directly involved in patient care; 55% held the role of the main caregiver. Ten key themes were investigated and the areas of negative impact by magnitude are: Emotional Impact (100%) citing worry, stress, and frustration; Financial Impact (100%) citing medical bills as the most burdensome; Family Relationships (82%) citing increased stress and tension; Sleep & Health (64%) citing sleep loss from having to wake to assist the patient; Daily Activities (63%) seeing caregiving as a burden; Social Life (58%) citing guilt feeling as a hindrance to socialization; Time Planning (57%) with the unpredictability of the patient's symptoms being the main cause of not being able to make plans; Holidays (48%) blaming appointments for not being able to go on vacation; Work & Study (43%) citing lack of focus; and Support & Medical Care (42%) citing lack of support from other family members. Positive effects were also identified with 90% reporting strengthened personal relationship with the family, 83% having more awareness of their diet, 80% having strengthened faith, and 77% noting a closer family as a result. Relationships between these themes were discussed.CONCLUSION: As revealed, dialysis-requiring kidney disease has several negative impacts on the quality of life of involved families. If left neglected, the family, instead of being a resource in patient care, may become a barrier. Strategies to employ the positive effects as enablers in managing the areas of negative impact must be developed to provide appropriate support for the patient and the family unit. 

Ciudad/metrópoli, subjetividad y valorización en el marco del capitalismo financiariado / City/metropolis, subjectivity and valorization within the framework of the financialized capitalism

En este artículo se analizan, desde un punto de vista crítico, algunos de los rasgos fundamentales de las transformaciones acontecidas en las ciudades/metrópolis del capitalismo globalizado en las últimas tres décadas. Se aborda el impacto de la economía financiarizada en las dimensiones espacial, económica, política, social y psicosocial. Las consecuencias de aquellas determinaciones quedan reflejadas en distintos procesos, entre los que destacaremos: la función determinante de la praxis del activo financiero en la relaciones productivas/reproductivas y del capital circulante; la reconfiguración de los sistemas urbanos y arquitectónicos con arreglo a los nuevos formatos que compartimentan y bunkerizan espacios; y, por fin, la esfera simbólica y discursiva de la subjetividad/intersubjetividad. En suma, se trata de deconstruir la ciudad/metrópoli, basada en una axiomática de relaciones sociales monetizadas y de poder asimétrico...

This article deals with, from a critical point of view, several basic features of the most important changes occurred in the cities/metropolis of the globalized capitalism in the last three decades. It is an analysis about the financial impact on spatial, economical, political, social and psychosocial dimensions. The effects of those determinations are reflected in different processes such as: the financial asset praxis influence in the productive/reproductive and circulating capital relations; the redesign of the architectural and urban systems, with regard to the new patterns that compartmentalize and bunkerize spaces; and, finally, the symbolic and discursive processes of the subjectivity/intersubjectivity. Finally, the aim here is to deconstruct the city/metropolis, based on an axiomatic of the monetized social links and asymmetric power...