title: Meaning of illness and illness representations, crucial factors to integral care.
abstract: BACKGROUND
  A comprehensive study of end-stage renal disease (ESRD) and haemodialysis (HD) must include the sociocultural dimension of illness and the experience of patients from their own perspective. It is critical for the caring team to know how the disease is lived and reinterpreted by the patient, as this knowledge could improve nursing staff/patient interaction. The meaning of their experience is also an influential factor on the caring methods utilised by the patient.
  
  
  METHODS
  The Theory of Representations and Explanatory Model of Illness was utilised in the study.
  
  
  METHODS
  A narrative qualitative methodology, grounded in a constructivist paradigm was used. Twelve patients were interviewed. The interviews were audio taped and transcribed verbatim.
  
  
  RESULTS
  Results revealed that patients have a range of beliefs about their illness and their treatment. Regarding identity, symptoms that arise at the outset of illness are not suspected of relating to renal failure. The inevitability of haemodialysis convinces patients of the presence of illness, opening a wide range of metaphors and symbolic representations.
  
  
  CONCLUSIONS
  Representations of ESRD and HD conform to a multidimensional corpus where different elements of scientific order and common sense converge and interact, such as beliefs and fears. All of these contribute to the meaning of this illness and its treatment. The attributed meaning is dynamic being continually elaborated based on illness outcomes, adaptation to treatment, particular events and the sociocultural environment.
authors.affiliation: Dialysis Unit, Fundación Jiménez Diaz-Capio, Madrid, Spain. evelez@fjd.es
authors.forename: E
authors.initials: E
authors.lastname: Vélez
authors.forename: M
authors.initials: M
authors.lastname: Ramasco
mesh_terms: D000223:Adaptation, Psychological; D000368:Aged; D001294:Attitude to Health; D015984:Causality; D018450:Disease Progression; D005239:Fear; D005260:Female; D006184:Habits; D006694:Holistic Health; D006801:Humans; D007676:Kidney Failure, Chronic / Q000209:etiology / Q000523:psychology* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D008960:Models, Psychological; D033262:Narration; D009341:Negativism; D015404:Nursing Methodology Research; D036301:Qualitative Research; D011788:Quality of Life / Q000523:psychology; D006435:Renal Dialysis / Q000523:psychology*; D012649:Self Concept; D012718:Set, Psychology; D012803:Sick Role; D011795:Surveys and Questionnaires; D013561:Symbolism