title: Toward a trajectory of adjustment in women with end-stage renal disease on haemodialysis.
abstract: OBJECTIVE
  To examine the lived experiences of community-dwelling women with end-stage renal disease undergoing haemodialysis treatment.
  
  
  BACKGROUND
  End-stage renal disease is a chronic progressive disease with renal transplantation as a major treatment option. However, the majority of patients choose haemodialysis as their primary treatment. In this disease, many changes occur in the body that demand adjustment in every aspect of these patients' lives. The turbulent trajectory of adjusting to this disease and treatment has been under-researched. Given the increased number of patients requiring haemodialysis, a fuller understanding of the experienced disease course is essential in guiding clinical efforts.
  
  
  METHODS
  Descriptive phenomenology was used as it suited the purpose of this study.
  
  
  METHODS
  Sixteen adult women from two large haemodialysis centres in a large Midwestern city in the USA were interviewed. All data were analysed using Colaizzi's methodological interpretation.
  
  
  RESULTS
  Three major themes emerged supporting a possible adjustment trajectory: initiation-the initial phase of adjustment; appreciation-the middle phase of appreciating haemodialysis treatment; and grappling-the later phase of dealing with adverse effects from haemodialysis. The findings, however, suggest that experiences in the adjustment trajectory are interwoven, circular and ongoing, rather than linear.
  
  
  CONCLUSIONS
  More research is needed in this under-researched area to guide practice for meeting the demands of this growing patient population.
  
  
  CONCLUSIONS
  These results provide knowledge that can assist nurses to implement care that is tailored to support adjustment, thus minimizing setbacks and improving patients' well-being.
authors.affiliation: Preventive Care Program, Loma Linda University, Loma Linda, CA, USA. rtanyi@yahoo.com
authors.forename: Ruth A
authors.initials: RA
authors.lastname: Tanyi
authors.forename: Joan Stehle
authors.initials: JS
authors.lastname: Werner
mesh_terms: D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000628:therapy; D016030:Kidney Transplantation; D006435:Renal Dialysis