Sixteen nurses working at the hemodialysis units had been interviewed for psychiatric assessments of their adaptational problems associated with chronic hemodialysis procedure. M MPI and psychiatric rating scales were used to compare with other nurses working at the general wards. Most of them had started their with enthusiasm and empathy. However, gradually confronting monotonous environment of the units, and depressive mood, dependent, and demanding attitude and impulsive behaviors related with repressed instinctual needs of their patients, they began to feel anger, frustration, guilt and finally indifference. Only three nurses reported successful adaptation. Tese poor adaptation had caused obsessiveness, increased sensitivity, hypochondria and somatization reactions in the half of the nurses, especially with personality problems. These findings suggest that mental mechanisms of repression and denial are involved. Personality and religious belief were the variables that were associated with successful adaptation. All the nurses believed that psychatric helps are needed for the chronic hemodialysis patients, and they had combined the supportive psychotherapeutic techniques with their routine medical nursing cares. These findings suggest that, in chronic hemodialysis, multimodal approach including psychiatric intervention is essential for the whole treatment procedures including treatment personnels as well as the patients.
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