title: Exploring patients' attitudes to different intervention approaches for supporting psychosocial needs.
abstract: BACKGROUND
  Many patients with end-stage kidney disease (ESKD) have significant psychosocial needs as a consequence of their illness and treatment. Unmet needs can impact negatively on their health and well-being. Patients want improved psychosocial support particularly in relation to coping and adjustment. Little is known about the relevance and applicability to patients of intervention approaches to support their psychosocial needs.
  
  
  OBJECTIVE
  To explore patients' attitudes to different intervention approaches that could be developed to help them cope with the psychosocial stressors of ESKD, and to assess the potential acceptability of these approaches.
  
  
  METHODS
  Qualitative interviews and mini-focus groups were undertaken with 15 patients who have ESKD. Different intervention approaches were shown to participants through use of audio-visual films. Constant comparative data analysis was employed to derive a framework of categories and themes, guided by stress and coping theory.
  
  
  RESULTS
  Psychosocial support was viewed by patients as an essential constituent of quality care. While some intervention approaches were more or less popular than others, responses were overall variable and individualistic, seemingly influenced by participants' personal coping strategies. Any perceived connection with depression could make an intervention approach less attractive; physical exercise was particularly acceptable because there was no explicit association with someone not coping.
  
  
  CONCLUSIONS
  There is value in clinicians making available a choice of appropriately timed and tailored interventions to meet patients' different psychosocial support needs at key points of distress across the ESKD pathway. Congruence between intervention features and patient coping style could stimulate interest and take-up.
authors.affiliation: Institute of Applied Health Research, University of Birmingham, Birmingham, UK.
authors.forename: Francesca
authors.initials: F
authors.lastname: Taylor
authors.affiliation: Royal Wolverhampton NHS Trust, Renal Psychology Service, New Cross Hospital, Wolverhampton, UK.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Hare
authors.affiliation: Institute of Applied Health Research, University of Birmingham, Birmingham, UK.
authors.forename: Gill
authors.initials: G
authors.lastname: Combes
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D000368:Aged; D001294:Attitude to Health; D005260:Female; D017144:Focus Groups; D006801:Humans; D007676:Kidney Failure, Chronic / Q000523:psychology*; D008297:Male; D008875:Middle Aged; D010379:Peer Group; D000072858:Psychosocial Support Systems; D036301:Qualitative Research; D013315:Stress, Psychological / Q000628:therapy*; D055815:Young Adult
keywords: Coping; Distress; End-stage kidney disease; Psychosocial