Couples coping in response to kidney disease: a developmental perspective

In this article we suggest that the treatment of patients with end-stage renal disease (ESRD) should be informed by three developmental perspectives. In addition to the changes in the progression of the illness and its treatment demands over time, clinicians should consider psychosocial changes and challenges related to the developmental life stage of the patient (e.g., retirement) and the evolution of the patient's romantic relationship along a variety of dimensions that may affect his or her ability to cope with the disease (e.g., emotional support, conflict, sexual functioning). We briefly review the existing literature in each area and argue that integrating all three perspectives will facilitate the long-term treatment success and patient's adjustment to the illness. Finally, we discuss the implications for the development of prevention and treatment interventions with patients and their spouses or partners and the importance of considering ethnic and cultural variations in treatment.