title: Effects of an adaptation training programme for patients with end-stage renal disease.
abstract: OBJECTIVE
  This paper reports a study investigating the effectiveness of an adaptation training programme (ATP) to help patients with end-stage renal disease (ESRD) to cope with illness-related stresses and, thus, to alleviate depression and improve quality of life.
  
  
  BACKGROUND
  Patients with ESRD who receive dialysis must confront the burdens of long-term illness and numerous treatment-associated stressors. The ability of these patients to cope with and adapt to these stresses, whether related to their medical regimen or to the demands of daily life, has an important influence on physical and psychological well-being.
  
  
  METHODS
  The study was a randomized controlled trial using a convenience sample of 57 eligible, fully informed and consenting patients with ESRD who were assigned to experimental (ATP plus usual care) or control (usual care) groups. Participants in the ATP took part in weekly small group sessions over an 8-week period and monthly follow-up to help them to cope with stressors. A clinical nurse specialist and an experienced psychotherapist led them in three small groups (8-10 per group). Participants in the usual care group received routine care. Instruments comprised the Haemodialysis Stressor Scale, Beck Depression Inventory and Medical Outcomes Study SF-36. Data were collected at baseline and at three months following the intervention.
  
  
  RESULTS
  The major stressors for these patients were limitations on time and place related to employment, limitations on fluid intake, transport difficulties, loss of bodily function, length of dialysis treatment, and limitation of physical activities. The ATP had a beneficial effect on perceived stress (P = 0.005), depression (P = 0.001) and quality of life (P = 0.02) 3 months after the intervention.
  
  
  CONCLUSIONS
  This study supports the effectiveness of an ATP to decrease stress and depression levels, and to improve the quality of life of ATP patients receiving haemodialysis.
authors.affiliation: National Taipei College of Nursing, Graduate Institute of Nursing, 365 Ming Te Road, Pei-Tou 112, Taipei, Taiwan. sltsay@mail1.ntcn.edu.tw
authors.forename: Shiow-Luan
authors.initials: SL
authors.lastname: Tsay
authors.forename: Yuh-Chain
authors.initials: YC
authors.lastname: Lee
authors.forename: Yueh-Ching
authors.initials: YC
authors.lastname: Lee
mesh_terms: D000203:Activities of Daily Living; D000223:Adaptation, Psychological; D000328:Adult; D000704:Analysis of Variance; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007676:Kidney Failure, Chronic / Q000451:nursing / Q000523:psychology* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D009720:Nurse Clinicians; D011613:Psychotherapy / Q000379:methods*; D011788:Quality of Life; D006435:Renal Dialysis; D016896:Treatment Outcome