End stage renal disease and the marital dyad: an empirical investigation

The psychological well-being of end stage renal disease (ESRD) patients and spouses was investigated from a dyadic perspective. The responses of patients and spouses from five groups of couples--illustrating different points in the progression and treatment of ESRD--were compared both across ESRD groups and between patients and spouses. Despite the fact that the ESRD groups reflected differences in illness/treatment intrusiveness, no significant differences were found between the ESRD groups, or between patients and spouses, in either marital relations or psychological well-being. However, while for all the participants marital role strain was a significant predictor of psychological well-being, the two dialysis groups evidenced significantly greater correlations between marital role strain and psychological distress than the nondialysis groups. These findings are interpreted as being consistent with a general systems theory approach to the conceptualization and treatment of chronic illness.