Twelve home hemodialysis patients and their spouse‐assistants were evaluated to determine how the interaction between the marital partners affected their marital satisfaction, degree of psychopathology, physical health and effective performance of dialysis‐related tasks. The data suggested that the patient's medical adaptation is enhanced when there is a non‐conflictual relationship and when the spouse makes a positive emotional adjustment to home dialysis, experiencing few somatic complaints. Professional attention, therefore, should shift from the traditional focus on the patient alone to include assessment of the marital relationship and the physical and psychological well‐being of the spouse‐