Guarded alliance relationships between hemodialysis patients and their health care providers

To further understand the complex patient-nurse relationships surrounding end stage renal disease. Thorne and Robinson's (1987: 1988a, 1988b) framework of guarded alliance was found to be most useful. In this study, we interviewed five patients regarding their perceptions of the patient-nurse relationships they had experienced while receiving hemodialysis treatment. Our study finds that this model is very useful in understanding these ever-changing relationships. Content analysis of the transcribed interviews indicated that patients experienced all of Thorne and Robinson's relationship stages including naive trust, disenchantment, and guarded alliance. Interestingly, we also found that patients may experience the same stages of "relationship" with their dialysis machine as well.