Immersing in problems: Challenges of women living with the husband on hemodialysis

Abstract

Background & Aim: The caregivers of hemodialysis patients experience a heavy caregiving burden. More caregiving pressure and burden have been reported of the women than men insofar as they are encountered with more physical and psychological problems. This paper explores the challenges faced by women living with husband on hemodialysis. Methods & Materials: The study followed a conventional content analysis method. The participants were selected through a purposive sampling method in hospitals of Shahid Beheshti University of Medical Sciences, Tehran, Iran, in 2017-2018. The first author performed semi-structured, individualized interviews with 14 participants. Results: By analyzing the data, the main category "Immersing in problems" was extracted with two following categories: 1- Inadequate support network (subcategories: inadequate informational support, inadequate instrumental support, inadequate emotional support) and 2- Difficult coexistence with problems (subcategories: role overload, worry and anxiety, fear and hope for the future, suffering of frequent dialyses). Conclusion: The findings of the study showed that women living with the husband on hemodialysis have been encountered with challenges and numerous stressing factors in the course of caregiving. Given the challenges experienced by participants, telenursing, and community health nurses can play an essential role in eliminating the many problems of hemodialysis patients and their caregivers.

Caring for patients with end‐stage renal disease during COVID‐19 lockdown: What (additional) challenges to family caregivers?

“…These requirements increase patients' dependence on family caregivers, who are crucial for the provision of care and support [12]. As a consequence, family caregivers have to readapt their personal, family, social and labour activities to fit the demands of ESRD care [7,10,13,14].…”

“What do we fear the most?”: Exploring fears and concerns of patients, family members and dyads in end‐stage renal disease

“…Worldwide, haemodialysis (HD) is the most common form of treatment (2)(3)(4). Although it allows patients to extend their life expectancy (5), this treatment is highly complex and requires several restrictions and life readjustments, not only for the patients but also for their family members (1,4,6,7). Patients need to adhere to a restrictive diet and fluid intake (6,8) and regularly attend to dialysis centres or consultations, hospitals, and clinics, and take different medications.…”

“…Due to its strict regime of attendance (3-4 times a week, with each session lasting up to 4 fours), HD can easily become a routinised activity that does not consider the psychological distress it causes on patients and families. However, several studies have shown that patients with ESRD undergoing HD may experience severe stress (7), anxiety (10), fear (11)(12)(13) and uncertainty about the future (14,15). A recent study found that most patients with this condition lived in fear of the disease and were scared about their future as they felt dependent on dialysis and could not survive without it (16).…”

“…Several patients also mentioned concerns about their frailty which can increase dependence on family members, especially on the carer who represents the main source of support (16). Thus, close family members also experience anxiety (7) and burden (17), and their lives may be considerably altered due to the challenges that ESRD and HD impose on the family structure and on the carer's life (7,13).…”

“…However, studies focusing on the fears and concerns of patients with ESRD undergoing HD are still scarce and these themes are poorly explored in the current literature. Most studies with this population are patient-centred; however, patients with this condition have to manage several disease requirements and constraints that impact the entire family (7). Also, it is possible that fears may vary according to the respondent since patients' and family caregivers' may perceive different threats associated with the disease and its treatments.…”