Impact of Dialysis on the Dyadic Relationship Between Male Patients and Their Female Partners

Abstract

The objective of this study was to explore the impact of three early phases of renal dialysis, namely pre-dialysis, starting dialysis, and establishing dialysis, on dyadic relationships. Twenty UK-based dyads (20 male patients and their female partners) participated in semi-structured interviews and discussed the effects of dialysis on themselves and their relationship. Dyadic thematic analysis, facilitated by dyadic-level charting, integrated participants’ experiences and enabled identification of patterns across dyads. We found that dialysis had positive and negative influences on identity, social relationships, and mental health, forming the themes: Prioritizing the Patient, Carrying the Burden, and Changing Identities. The final theme, Managing the Relationship, described how dyads prevented dialysis from negatively impacting their relationship. Dyadic-level charting provided a systematic examination of individual and dyadic experiences. These findings indicate that access to informational and support services for dyads as they prepare to start dialysis may minimize negative effects on their relationship.

Development of a measure for patients preparing to start dialysis and their partners: The Starting Dialysis Questionnaire (SDQ)

“…The data used in this phase of the study were part of an over-arching, cross-sectional, qualitative study which explored the impact of the early phases of dialysis on patients and their partners [ 3 ]. The early phases of dialysis were defined as the period when patients are preparing to start dialysis (e.g., pre-dialysis) and are adjusting to dialysis [ 1 ].…”

“…Previous qualitative research found that psychological and interpersonal factors within the dyad played an important role in adjusting to dialysis and minimising the impact of it on the dyadic relationship and quality of life (QOL) [ 3 ]. Moore et al .…”

“…Moore et al . [ 3 ] interviewed both members of 20 dyads at various times around the start of dialysis. Patients and their partners described significant changes in their identities, roles within the relationship and responsibilities.…”

“…A scoping review of the literature yielded 16 existing questionnaires which measured constructs related to relevant (on the basis of our previous qualitative work) [ 3 ] psychological and interpersonal factors (7 on dyadic coping, adjustment or satisfaction, 6 on illness cognition, 1 on couples’ communication, 1 on optimism and 1 on expectations for QOL and health after renal transplants). Each questionnaire was reviewed on the basis of the following criteria: (1) it addressed psychological or interpersonal relationship dynamics, (2) it was amenable to changes in wording (e.g., if a general questionnaire about illness, it needed to be possible to change “illness” to “kidney disease” or “treatment” to “dialysis”) and (3) it was applicable to patients and their partners.…”

“…Therefore, this search indicated that no measure existed which assesses the psychological and interpersonal factors related to maintaining the dyadic relationship and QOL, as described by Moore et al . [ 3 ].…”