Objective: Relaxation and imagery techniques have been widely used among patients with chronic physical illnesses other than end stage renal failure (ESRF).  Case studies and some controlled studies suggest that relaxation and imagery techniques can be successfully used with hemodialysis patients to improve their adjustment. Nonetheless, randomized controlled studies are needed to systematically examine this effect.

Method: The present study examined the effect of a specific visual imagery technique on adjustment and quality of life in a sample of 153 hemodialysis patients. Control procedures included an active control and a no-treatment control. The former consisted of relaxation training and general imagery techniques. Outcome variables included beliefs about hemodialysis treatment, ways of evaluating life, emotional adjustment, and quality of life. The ESRF Beliefs Questionnaire, the Life Evaluation Questionnaire for Hemodialysis Patients, the Hospital Anxiety and Depression Scale, the Ladder Scale, and 2 SF-36 summary scales were used to measure these outcome variables. 

Results: The findings show that the specific imagery intervention did not have an effect on emotional adjustment or quality of life, either post-treatment or at follow-up; however, the rate of patient compliance with the interventions was moderately high and patients reported that they were satisfied with the intervention procedures.  

Conclusion: The present study is the first randomized controlled intervention study of the effects of relaxation and imagery on adjustment in hemodialysis patients.  The findings are discussed in terms of their implications for future studies as well as their limitations.