BURDEN OF SELF-CARE IN SERIOUSLY ILL PATIENTS - IMPACT ON ADJUSTMENT

Perceived, but not actual, control over treatment has been consistentl y related to better adjustment in chronic illness. This study examined the relationship between actual control over treatment and severity o f illness and their influence on depression in a chronically iii popul ation of end-stage renal disease (ESRD) patients. The authors hypothes ized that as severity of illness increases, the burden of control over treatment would increase depression. Severity of illness and depressi on were assessed for 98 ESRD patients. Control over treatment was repr esented by whether dialysis patients were self-administering treatment (high control) or were receiving treatment from the medical staff(low control). Results indicated that for the most severely ill patients, high control over treatment resulted in poorer adjustment. Furthermore , this effect was due in part to how illness interferes with social re lationships in seriously ill, self-care patients.