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Human Services


Scott Hershberger


Although prior researchers have suggested that end-stage renal disease (ESRD) patients experience depression that impacts their adherence to treatment and quality of life, there is a lack of understanding of how ESRD patients experience anticipatory grief related to their mortality and loss. This lack of knowledge has made it challenging for social workers to address treatment adherence and palliative care issues during the care planning process. The purpose of this qualitative study was to explore perceptions of loss and grief of ESRD patients who were undergoing hemodialysis treatment. The conceptual framework was anticipatory grief, specifically how patients perceive their own death and impending loss. A case study design was used. The research questions addressed how ESRD patients describe their experience with anticipatory grief while receiving hemodialysis at different points of time. The data came from interviews with 10 dialysis patients; the interviews were comprised of 16 questions. Using cycling coding, the thematic analysis process was administered to uncover familiar themes. The findings revealed common anticipatory grief indicators among the participating ESRD patients. The participants also expressed the lack of end-of-life planning. A conclusion is that end-of-life and palliative care educational programs, along with interdisciplinary training, need to be customized for ESRD patients, a change that may help to improve their quality of life. The findings may serve as a catalyst for further research to explore standardize tools and interventions to support patients experiencing anticipatory grief.

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