Prioritising the patient: a qualitative study exploring the impact of dialysis on dyadic relationships

Abstract

Background: Research suggests that the period leading up to, and commencement of, dialysis is burdensome for patients and their significant others as they adjust to the demands of the treatment. Few studies have examined how dyads manage their relationship during this time period. The aim of this qualitative study was to explore the impact of pre-dialysis and dialysis on the dyadic relationship. Methods: 22 dyads (2 female patients, 20 female significant others) were recruited from a UK hospital’s outpatient clinics. Interviews conducted with each member of the dyad explored the effects of dialysis, or preparation for it, on this relationship. Dyadic thematic analysis was used to examine dialysis’ effects within each relationship and to identify patterns occurring across the sample. Findings: Prioritising the patient emerged as the central theme. The majority of the dyads reported that preparing for and starting dialysis had minimal negative impact their relationship despite patients being actively prioritised. However, when relationship factors were examined in these dyads, significant others often assumed key roles which emerged as the themes carrying the burden and managing the relationship. Adopting these roles had both positive and negative effects on their identity, social relationships and mental health during these stages. Discussion: This study showed the crucial role that significant others play during the early yet critical stages of treating renal failure. By engaging with and offering support focused on significant others, health care professionals may see positive outcomes for patients as well.