Social networks and social support: living with chronic renal disease.

Individuals with chronic renal disease who receive dialysis treatment are continually faced with major adjustments. These may include dealing with changes in work and economic status, social roles, activity levels, self-image, health status, and normal routines, as well as learning to live with uncertainty and loss. The individual's social network plays a key role as the individual experiences and moves through various stages of adjustment. Networks with certain characteristics (e.g. provision of affective support, reciprocal ties) may be more effective than others lacking these characteristics in meeting the individual's changing needs during the process of adjusting to chronic renal disease. This paper examines this relationship between the characteristics of an individual's social network and adjustment to chronic renal illness. The discussion focuses on the impact of chronic renal disease on the individual, the composition and characteristics of the social network, and on the relationships between network members. How the social network affects a person's adjustment to stages of adaptation to chronic renal disease is also addressed. Finally, suggestions are presented for how health care professionals can intervene at the individual, network, and organizational level to strengthen and enlarge social networks in order to enhance social support.