Data collection
weight gain, Depression, ESRD
ESRD, SECONDARY, END-STAGE RENAL DISEASE, RENAL
The primary and secondary outcomes were hope and adherence to treatment, respectively. Data collection tools included a demographic information form, Snyder Hope Scale, End-stage renal disease adherence questionnaire (ESRD-AQ), laboratory evaluations such as Blood urea nitrogen (BUN), creatinine, phosphate, and potassium, and inter-dialytic weight gain.Both groups completed the questionnaires of hope and adherence to treatment before and three months after the intervention. Similarly, the laboratory tests and inter-dialytic weight gain were measured before and three months after the intervention. In both intervention and control groups, BUN, creatinine, and phosphate levels were measured using similar kits (Man). A similar device (easy light) was also used to measure the potassium level. Furthermore, the patients' weights were measured using the calibrated scales in the centers. Finally, the inter-dialytic weight gain was calculated by subtracting the post-dialysis weight from the pre-dialysis weight in each session. The mean weight difference between the two consecutive dialysis sessions was then calculated as the final score.Snyder Hope Scale was developed by Snyder et al. in 1991. In this 12-item questionnaire, the items could be responded via a five-point Likert scale ranging from completely disagree (score 1) to strongly agree (score 5), while the scoring was inverted for items 3, 5, 7, and 11. A higher score on the questionnaire indicated a higher hope in the respondents. Snyder et al. reported a negative correlation of 0.44 with the Beck Depression Inventory to assess the simultaneous correlation validity [ESRD-AQ was developed by Kim et al. in 2009. This questionnaire consisted of 46 questions/items divided into five sections. The first section pursued general information about the patients' history of ESRD and Renal Replacement Therapy (RRT) (5 items), while the remaining four sections asked about adherence to treatment (14 items), medications (9 items), fluid restrictions (10 items), and diet recommendations (8 items). These four final sections directly measured the adherence behaviors and the patients' knowledge and perceptions about the treatment. The ESRD-AQ items could be responded via Likert scales, multiple choices, or “yes/no” options. The scores of the questionnaire could range from zero to 1200, with higher scores representing higher adherence to treatment [