Between Survival and Sacrifice: Marital Experiences of Patients Undergoing Hemodialysis.
Seher Çakmak, Hicran Karataş
PMID 42618051WHAT IT FOUND
Married dialysis patients described dialysis as reshaping their marriages through fatigue, social isolation, gendered expectations, sexual pressure, and in-law interference.
Some felt grateful for family support yet resentful when relatives did not offer kidney donation.
Key findings
01Fourteen of 23 participants described dialysis as a vicious circle of pain and relief, with many planning household tasks before sessions to manage post-dialysis fatigue.
02Nine of 23 participants preferred keeping in-laws involved despite discomfort because they feared needing care later; the most distressing interference included criticism, comparisons, and reminders of dependence.
03Ten participants whose spouses verbally offered kidney donation felt relational contentment, while ten others resented spouses who did not express willingness.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The study included only 23 patients from one dialysis center in Ankara, so it may not apply to patients in other regions, cultures, or dialysis settings. Only patients were interviewed, not spouses, in-laws, or healthcare providers, so the family and care-team perspective was missing. Experiences were self-reported and sensitive topics such as marital conflict, sexuality and family interference may have been affected by recall or social desirability bias. Interviews took place in the dialysis unit while patients were undergoing treatment, although no participant asked for a more private setting. The sample required at least five years of hemodialysis and excluded transplant recipients, never-married patients, and patients with cognitive or psychiatric conditions that prevented communication. The themes describe patients' experiences and perceptions; they do not test whether any nursing or family-centered intervention improves outcomes.
Declared interests
The authors declared no conflicts of interest and reported nothing to disclose.
The easy way to misread this
Do not read these themes as evidence that family counseling, nurse-led assessment, or peer support improves dialysis outcomes. This was a qualitative study of 23 patients' experiences, not a tested intervention.