Judy Stevens


The purpose of this study was to determine the coping mechanisms used by clients with end-stage renal disease and their significant others. This descriptive, comparative study was guided by the hypothesis: Clients and significant others of home hemodialysis use different coping mechanisms from the clients and significant others of in-center hemodialysis. Orem's Nursing Systems Theory provided the theoretical framework. The sample (N = 43) consisted of 12 home hemodialysis clients and 12 home significant others and 12 in-center hemodialysis clients and 12 in-center significant others who resided in East Central, West Central, and Central Mississippi. Data were collected utilizing the self-administered Coping Resources Inventory form. The two-tailed t test was used to analyze group differences. The null hypothesis was rejected as a significant difference in coping mechanisms between the groups emerged. The researcher concluded that the in-center group used more coping mechanisms in the cognitive, emotional, and social domains of coping than did the home group. Implications for nursing included continued application of Orem's Nursing Systems Theory to nursing practices involving in-center and home dialysis treatment. There is a need for the nurse practitioners to assess the interdependent relationships and coping strategies of the hemodialysis client and significant other in an effort to develop collaborative plan of care. Further implementation of quality care could be enhanced by the identification of the level of adaptation and stage of self-care of the dialysis client. Further research is warranted to explore these coping mechanisms, employ different tools to measure domains of coping, identification of specific coping mechanisms, identification of levels of adaptation, identification of level of self-care of the client and significant other, and a comparison of coping mechanisms between clients who are married to the significant other.


Master of Science in Nursing (MSN)


Graduate Nursing

Degree Date


Publication Number


First Advisor

Mary Patricia Curtis

Document Type


Included in

Nursing Commons