Characteristics of couples with poor outcome in dialysis home training

Certain emotional reaction patterns of the couple, (rather than just that of the patient, as stated by Shea) [18] to the need for chronic dialysis may represent the greatest obstacle for successful rehabilitation. A selection procedure which considers the response of a spouse as part of a functional unit will enhance the chances of success, at least in the initial training. From this study several observations seem important. First, older couples generally handle the stress and demands of home training less well. Secondly, couples who respond to stress similarly (the identifiers) have more difficulty; in particular, this holds when the patient has a strong tendency toward excessive denial, dependency or regression. Conversely some hostility or anger on the part of the spouse may enhance rather than detract patient adaption to dialysis training and actually improve the chances of successful rehabilitation. Both of these factors may be of help in the successful selection of couples and prediction of a successful course of training for home dialysis.