Exploring Psychological Distress in Renal Services: Health Care Professionals and Patient Experiences

Electronic versions


  • Margaret Shakespeare

    Research areas

  • DClinPsy


This thesis explores psychological distress in health care professionals (HCP) and patients in renal settings across three chapters. Chapter one systematically reviewed the quantitative literature on burnout and job satisfaction in renal HCPs. The chapter pays particular attention to features of the environment which contribute to burnout and dissatisfaction. This paper found moderate to severe levels of burnout in renal HCPs, with multiple environmental contributors, including high workload and poor organisational and leadership support and perceived professional progression. The second Chapter qualitatively explored the lived experiences of patients who received the ‘Moncrief-Popovich Technique’ in preparation for transition to peritoneal dialysis (PD). This cross-sectional study utilised Interpretative Phenomenological Analysis (IPA), with semi-structured interviews. Four participants of equal gender split were recruited. Analysis revealed four interrelated super-ordinate themes capturing the participants’ experience of transition to PD; End of part of your life, Control the direction, not the outcome, Protection of the self and Moving onto the next step. Each super-ordinate theme carried sub themes which elaborated participants’ experience of fragmentation, identity fragility, adaptive coping and relationship forming related to decision making and perceived control. Participants used the embedded period as a time for maintaining normality and feelings of safety and containment; however, distress was present, as was expected when exploring transition. The third chapter explored implications for theory and clinical practice which emerged from the previous chapters. This chapter highlighted the importance of a dual approach to addressing distress in HCPs in order to adequately support patients’ distress. Organisational interventions based on psychological theory and national policy are recommended, including a psychologically informed implementation model. Personal reflections of the research process and outcomes are also considered.


Original languageEnglish
Awarding Institution
    Award dateJan 2016