Keywords: Illness perceptions
Dialysis
Health-related quality of life
ESRD
Social support
Mortality
Self-rated health
Symptoms
Symptom clusters


Patients’ perceptions can influence their responses to end-stage renal disease (ESRD) and dialysis, and subsequent health outcomes such as health-related quality of life (HRQL) and survival. This thesis explores the association between illness perceptions and health outcomes of patients on dialysis. For example, we found a single self-rated health (SRH) item: ‘How would you say your health is in general’ to be a strong predictor of mortality. Patients who perceive their health as poor, fair or good had a higher mortality risk than those with excellent/very good health, independent of a range of risk factors. Compared with haemodialysis (HD) patients, peritoneal dialysis (PD) patients reported more personal control and had a better understanding of the illness. Patients who perceived having more symptoms, more consequences and lower personal control reported poorer HRQL. In terms of social support, both HD and PD patients who perceived a discrepancy between the received and expected levels of social companionship, daily emotional support, and total support had a higher risk of mortality. However, patients who received or perceived having inadequate emotional support with problems had no higher mortality risks. Therefore, different aspects of social support is of varying importance to dialysis patients.