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Background/Aims: People receiving in-centre haemodialysis (ICHD) during the COVID-19 pandemic had to adjust to more challenging treatment conditions. This article aims to explore people's experiences of adjustment to ICHD during the pandemic. Methods: Thematic analysis of in-depth, semi-structured interviews with 14 adult UK ICHD patients. Findings: A total of four themes were identified: perceptions of the threat, impacts on treatment, impaired communication and coping and positive adjustment. These themes described participants' experiences of vulnerability to COVID-19; the ways the pandemic affected dialysis and clinical care; the impact that measures to reduce viral transmission had on communication and interaction within dialysis units; and ways that participants coped and made positive adjustments to the adversities imposed by the pandemic. Conclusions: The findings give insights into adjustment during extreme adversity. They also help to identify how support for ICHD patients could be improved as pandemic conditions recede and ways that dialysis units could prepare for future outbreaks of infectious illness.

Background: Many people with end-stage chronic kidney disease continued attending clinical centres for dialysis despite the risk of contracting COVID-19 and developing severe disease. Aims: To assess the impact of COVID-19 on patients' adjustment and wellbeing. Methods: Some 40 people (18 female, 22 male) receiving in-centre haemodialysis reported COVID-19-related adverse impacts on treatment and rated their COVID-19-related concerns, then completed the Depression, Anxiety and Stress Scale-21 and four scales of the Kidney Disease Quality of Life Short Form. Findings: The most common adverse impacts were staff shortages/changes and impaired interaction with staff/patients. Of the sample, 32.4% were severely depressed, 14.7% severely anxious and 18.9% severely stressed. Participants who had tested positive for COVID-19 were more depressed and reported more adverse impacts. Older and married/cohabiting participants had better adjustment and wellbeing. Conclusions: The results help to identify patients with the greatest needs and suggest ways to maintain patient wellbeing during outbreaks of infectious disease.