| This research builds on the notion that psychological stress negatively impacts health. Three studies were performed to assess the nature and relationship of psychological factors in Black patients with end-stage renal disease (E.S.R.D.) who were receiving hemodialysis and to see if a psychological intervention would prove beneficial psychologically and/or physiologically. In Study 1, a number of psychological instruments were analyzed for their association with key physiological measures of the disease. Results suggest a strong relationship between a number of psychological factors including negative mood, perceived stress, self-esteem, life-orientation, anxiety and critical physiological indices related to both kidney functioning and compliance to treatment regimen. Study 2 tested two psychological interventions against a control group. The first intervention was based on Steele's (1988) theory of self-affirmation. The second intervention, consisting of emotional expression, was based on the theory of inhibition (Pennebaker, 1989). Results indicated that self-affirmation positively impacted phosphorus, perceived stress, positive mood, loneliness, and depression. Emotional expression tended to buffer the natural decline seen in life-orientation but negatively impacted (increased) depression. Study 3 was a replication of study 2 that eliminated the emotional expression condition and the depression scale for logistical reasons. Self-affirmation had an impact on positive mood and life-orientation, but the effects on phosphorus failed to replicate significantly. When the data from the two studies were collapsed, perceived stress was shown to be significantly reduced by self-affirmation. The findings are discussed in terms of their practical and theoretical implications. |
