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Acknowledgments: This research was supported in part by grants made available to the author by the National Institute of Nursing Research, Center for Enhancing Quality of Life in Chronic Illness (P30 NR05035-01), and the American Nephrology Nurses' Association (ANNA). The views expressed herein are those of the author. No official endorsement by the ANNA is intended or should be inferred.

The author thanks Doris Byers, Barbara Hasbargen, Lydia Carrasquillo, Clifford Blake, and Kim Dixon for their help with data collection; Dr. Victoria Champion for her help with confirmatory factor analysis; Drs. Joan Austin, Victoria Champion, and Phyllis Dexter for their helpful comments and editorial assistance; and the panel of experts who willingly gave their time and expertise when reviewing the proposed items. Finally, appreciation is extended to the participating patients who generously gave their time and energy to this project.

Note: Correspondence concerning this article should be addressed to Janet L. Welch, Department of Adult Health, Indiana University School of Nursing, 1111 Middle Drive, NU 414, Indianapolis, Indiana 46202. E-mail: jwelch@iupui.edu

Janet L. Welch PhD, RN, FAAN

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