COPING WITH INTIMACY - EXPERIENCES OF PEOPLE WITH RENAL DISEASE IN PARTNERSHIP

Abstract

The growing dialysis population is a worrying trend and makes research into the quality of life for this group even more crucial. One highly neglected aspect of quality of life is the sexual satisfaction and difficulties that end-stage renal disease (ESRD) patients and their partner face. As such issues are not life-threatening, it has become less of a priority as compared to other health concerns (Fernandes et al., 2010). Previous research on sexual intimacy issues have focused on the medical aspects of it and it has been well-established that both male and female ESRD patients are at a higher risk of sexual intimacy issues (Doss and Polaschek, 2012; Luk, 2001). A closely related issue is family-building and this study will focus on the psychosocial influences of these issues and look into how patients and spouses cope. Between January 2017 and March 2017, qualitative semi-structured interviews were conducted with eight participants, of which three are Haemodialysis (HD)/Peritoneal Dialysis (PD) patients, four are spouses of HD/PD patients and one is a Social Worker from the National Kidney Foundation Singapore (NKFS). All participants were recruited through the NKFS. Following that, transcendental phenomenological data analysis was conducted to identify the common themes. Of the seven patients and spouses interviewed, four faced sexual intimacy and/or family-building issues. Age of diagnosis is closely related to whether familybuilding is a concern. Family-building is a concern arising from ESRD when participants' or their spouses' age of diagnosis ranged from 18 to 34 years old. Findings from this study suggest that the factors that affect patients' and spouses' coping with sexual intimacy and/or family-building issues are: (i) pro-family religious beliefs, (ii) marital quality before the issues arose, (iii) other ESRD-related stressors (iv) negative reactions from family members, (v) congruence between the couple regarding the importance of sexual intimacy, and (vi) other medical factors. In coping with sexual intimacy and/or family-building issues, maladaptive coping strategies, appraisal-focused, problem-focused and emotion-focused constructive coping strategies were employed. Participants also shared their views about professional support and gave suggestions to enhance professional support. Their suggestions were considered along with the study's findings, and recommendations for practice were made. It is crucial for professionals working with ESRD patients and their spouses to start giving emphasis to sexual intimacy and family-building concerns. In particular, concerns about having children are extremely salient for young couples. In Singapore, discussions about sexual intimacy issues is still a cultural taboo but findings from this study show that there are culturally-appropriate and sensitive ways to approach this topic in order to better support ESRD patients and spouses.