Selection criteria and psychological adaptations to the ongoing dialysis and renal transplant programme

Doctoral Thesis


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University of Cape Town

The aims of the study were: - (1) to investigate the criteria of selection for an ongoing dialysis and transplant programme; and (2) to study psychological changes made by patients at various phases of the programme. A total sample of forty-five patients being treated at the Renal Department of Groote Schuur Hospital, Cape Town, were psychologically assessed. In studying the selection process, intellectual factors, social class, educational measures and personality factors were contrasted between a sample of patients accepted and rejected for the programme. In the investigation of the psychological changes occurring within the programme, total and directional hostility, intelligence, anxiety, dependency and self-control measures were contrasted between a predialysis, short-term dialysis, long-term dialysis and transplant sample. Results revealed!( 1) that the accepted sample had significantly higher verbal intelligence, educational and social class scores than the rejected group; (2) no significant differences in general hostility, anxiety, dependency and self-control measures between the patients at the various ongoing phases. However the long-term dialysis sample showed significantly more extra-punitiveness than the transplant sample while the transplant sample showed a significantly higher level of intellectual functioning than the predialysis and long-term dialysis groups. These results show that (1) selection is possibly based on superficial characteristics, with which the selection team can identify; (2) projection of hostility is a possible important defence mechanism used in coping with the rigorous demands of the programme; (3) due to the possible absence of toxic substances after transplantation, the transplant sample showed a higher level of intellectual functioning. Other possible explanations for the findings were provided.