Iran J Psychiatry Behav Sci. 2021 June; 15(2):e104490. Published online 2021 April 14. doi: 10.5812/ijpbs.104490. Research Article The Effect of Resilience Training on Stress, Anxiety, Depression, and Quality of Life of Hemodialysis Patients: A Randomized Controlled Clinical Trial Mehdi Amirkhani 1 , Nasrin Shokrpour 2, * , Leila Bazrafcan 3 , Ameneh Modreki 1 and Shima Sheidai 4 1 Department of Health in Disasters and Emergencies, School of Management and Medical Informatics, Shiraz University of Medical Sciences, Shiraz, Iran 2 English Department, Shiraz Uinversity of Medical Sciences, Shiraz, Iran 3 Education Development Center, Shiraz Uinversity of Medical Sciences, Shiraz, Iran 4 Fasa University of Medical Sciences, Fasa, Iran * Corresponding author: English Department, Shiraz Uinversity of Medical Sciences, Shiraz, Iran. Email: shokrpourn@gmail.com Received 2020 May 31; Revised 2020 December 05; Accepted 2021 January 30. Abstract Background: Today, the prevalence of psychological problems such as stress, anxiety, and depression in hemodialysis patients has increased and affected their quality of life. Objectives: Given the relationship between resilience interventions and psychological problems, this study aimed to investigate the effect of resilience training on stress, anxiety, depression, and quality of life in hemodialysis patients. Methods: This was a controlled clinical trial study on 57 hemodialysis patients referred to Fasa city hemodialysis centers from Oc- tober to December 2019. Patients were selected using a simple sampling method and divided into two groups of intervention (n = 29) and control (n = 28) using the block randomization method. In 12 sessions of a 90-minute workshop, the intervention group was taught resilience skills by a clinical psychologist. Before and after the intervention, stress, anxiety, depression, and quality of life were measured using the Depression anxiety stress scale (DASS) 21 and SF-36 questionnaires. Data were analyzed with Statistical Package for the Social Sciences (SPSS) software version 20 using t-test, Kolmogorov-Smirnov, and chi-Square tests. Results: According to the paired t-test, the patients’ mean score of stress, anxiety, and quality of life significantly decreased in the intervention group (P < 0.001), whereas depression score did not significantly change after the intervention (P = 0.689). The dif- ference in the mean scores of stress, anxiety, depression, and quality of patients’ life was not significant in the intervention group before the intervention and in the control group before and after the intervention (P > 0.05). Conclusions: Resilience training reduced stress and anxiety in hemodialysis patients and improved their quality of life. Thus the use of resilience intervention programs along with other methods for hemodialysis patients’ care and treatment programs is rec- ommended as a non-invasive, non-pharmacological, inexpensive, and cost-effective method without complications. Keywords: Anxiety, Depression, Education, Psychological, Quality of Life, Resilience, Stress 1. Background Chronic renal failure refers to an irreversible impair- ment of renal function; when the function of the kidney reaches less than 50%, and its capacity reaches less than 10 - 15%, it is considered to end-stage renal disease (ESRD) (1). According to previous studies, about 10% of the adult pop- ulation in the United States suffers from chronic renal fail- ure, and the prevalence of this disease is reported to be 20% in Iran (2). Patients with ESRD require alternative therapies, including hemodialysis or kidney transplantation. Hemodialysis is the most common treatment for these patients, which, despite prolonging their life expectancy, causes significant psychological, social, and physical prob- lems (3, 4). The results of many studies indicate a high prevalence of psychosocial disorders, including stress, anxiety, and depression, in these patients (5-8). About 34.5% of patients undergoing hemodialysis suffer from depression (9). In some studies, about 19 - 60% of the patients have been reported to suffer these problems (10). Moreover, 12 - 52% of these patients have anxiety (4), as the rate of hospitalization of hemodialysis patients in psychiatric wards is 1.5 to 3 times that of other chronic patients (11). Stress, anxiety, and depression are also very Copyright © 2021, Author(s). This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License (http://creativecommons.org/licenses/by-nc/4.0/) which permits copy and redistribute the material just in noncommercial usages, provided the original work is properly cited.