Evaluating the impact of a psychological intervention to reduce the severe stress and psychological morbidity of people with chronic kidney disease who are commencing maintenance dialysis: The Dialysis Optimal Health Program.

INTERVENTION: The Optimal Health program (OHP) is a collaborative therapy and selfefficacy intervention. The program is delivered to participants in a modular format over 8 sequential weeks followed by a booster at 3mths. It is delivered via telephone or face to face over 1hr by trained program assistants (Honours degree in psychology students from collaborating partner universities). Strategies used to monitor adherence to the intervention include participant use of a manual; and the requirement for program assistants to record file notes 1. The Optimal Health program (OHP) utilises a modular format. Each module encompasses a manualised discrete skill development intervention run over 8 weeks (plus booster session) involving: health promotion, interagency collaboration, accessible support care coordinator, understanding stress, family and community support. The modular format allows for tailoring of the intervention to suit the needs of adults with end stage renal failure (ESRF) transitioning to dialysis. Similarity across modules in terms of the core intervention, plus overlap between modules, enhances implementation through familiarity with the methods and style. This also addresses efficiency and cost‐effectiveness with respect to training staff. Each session is designed to build on the learnings from the previous session with the ‘I Can Do model’ as the core theme. 2. Rural patients are offered the program over the phone. The program is delivered 1 session per week for 8 sequential weeks. 3. The booster session at 3 months is one hour duration and the overall theme for this session is to address 'what is my health like now' for participants. This booster session will involve review of progress and reflection on achievements towards health‐related goals. CONDITION: anxiety chronic kidney disease depression end stage kidney disease stress PRIMARY OUTCOME: Composite depression and anxiety as assessed by the: Hospital Anxiety and Depression Scale (HADS) ; SECONDARY OUTCOME: Coping strategies as assessed by an abbreviated version of the COPE inventory (Brief‐Cope) Illness perceptions as assessed by the Brief Illness Perception Questionnaire (brief‐IPQ) Quality of life as assessed by the Kidney Disease Quality of Life scale (KDQoL) ; ; Self efficacy as assessed by the General Self‐efficacy Scale (GES) ; INCLUSION CRITERIA: 1. Patients with End Stage Kidney Disease (ESKD) who are expected to commence maintenance dialysis for the first time within the next three months or who have commenced dialysis in the past three months. 2. Age 18 years or above. 3. Able to converse in English without an interpreter. 4. Currently under the management of the Nephrology team at St. Vincent’s Hospital.