Effective Social Environment and Hemodialysis Adaptation: A Panel Analysis

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Abstract
Central to the theoretic orientation of the present panel analysis is the Meadian assumption that the attitudes and behavior of individuals are influenced by those with whom they interact on a continuing basis. By implication, the truth or falsity of that statement is particularly important for the victims of serious chronic illnesses whose ordinary patterns of interaction are disrupted and whose social involvements must be modified. In investigating the specific disease condition of renal failure with its associated treatment procedure, hemodialysis, this research examines whether a relationship exists between social environment, including the attitudes of family, friends and others contractually yet importantly related, and the chronically ill person''s modification of social functioning. Analysis of data collected through structured interviews at 2 times (T1 and T2) separated by a 3 yr interval finds statistically significant associations between patients'' perceived expectations of family and friends and the patients'' social functioning, initially and at the time of reinterview. Although the amount of interactional behavior appears to increase over time, the quality of such interaction clearly decreases. Alienation increases significantly over time. Partial correlational analysis of the relationships between major variables, controlling for the effect of education, suggests that although the perceived expectations of primary group members are clearly associated with social functioning at T1 and T2, the expectations of secondary group members cannot be so described in either instance. Clinical implications of these findings for the health care professional working with the chronic dialysis patient are discussed.

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