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I would like to express my especial gratitude and thanks to my co-supervisor Dr

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Acknowledgement

I offer my thanks to God for the blessings bestowed on me and for the successful completion of this thesis.

A great deal of personal effort was needed to successfully complete this thesis.

Nonetheless this would not have been possible without the kind support and help of many individuals and organizations. I would like to extend my sincere thanks to all of them.

I am highly indebted to my invaluable main supervisor, Associate Professor Dr.

Khatijah Lim Abdullah for her patience, guidance and supervision as well as for providing the necessary information and her support in completing this thesis. A millions thanks for her encouragement, helpfulness and quick response whenever I needed advice, but mostly for believing in me in all these years.

I would like to express my appreciation and gratitude towards my co-supervisor Associate Professor Dr.Wong Li Ping for her encouragement and guidance throughout the process of completing this thesis. Her immediate response to inquiries and uncertainties as well as her constructive criticism has helped me to improve my scientific skill set tremendously.

I would like to express my especial gratitude and thanks to my co-supervisor Dr. Lim Soo Kun for his time and expert advice. His critical comments helped improve the content of the thesis, particularly the clinical aspects of the study.

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A special thank you to the Medical Ethics Committee of University Malaya Medical Center and the Ethics and Medical Research Committee, Ministry of Health Malaysia for their approval to conduct this research in the Dialysis Unit of University Malaya Medical Center and the four public hospitals, namely Hospital Kuala Lumpur, Hospital Ampang, Hospital Serdang and Hospital Putrajaya,

I would like to express my thanks to the Directors, Head of Department of Nephrology and Nursing administration personnel of University Malaya Medical Center, Hospital Kuala Lumpur, Hospital Ampang, Hospital Serdang and Hospital Putrajaya, who have given me such a great opportunity to conduct research in their centers. Also, a big thank you to all hospital staff who have contributed their time in the course of conducting researchespecially during the data collection period.

My sincere thanks and appreciation to all haemodialysis patients who participated in this study.Thank you for answering all the questions, and for giving me your time andco-operation during the data collection process and the intervention.

Last but not least, I would like to express my deepest appreciation to my husband, Michael and to my girls, Patricia and Stephanie for their understanding, inspiration, love, and patience, and for putting up with me at all times of great distress.

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