Intensive care nurses need to enhance their knowledge and skills related to the use of technologies and patient care by attending training programs and gaining further education. This study recommends that hospital administrators should support sufficient facilities and technologies of care and, in particular, increase the competency of nurses in caring for critically ill patients as the whole person.

These findings provide an understanding of Thai nurses' perceptions about the challenges in communicating with patients experiencing ESKD regarding sexual health problems and concerns. The findings suggest that sexual health education and training would enhance the confidence of Thai nephrology nurses in initiating sexuality-related discussions with their patients.

Religion and spirituality provide powerful coping strategies that can help Thai people with CKD overcome the associated distress and difficulties. Religion and spirituality cannot be separated in Thai culture because Thai people are both religious and spiritual.

Thai patients with ESRD felt treatment, including HD, adversely affected their lives and required physical, psychological and social changes to enable them to cope. They reported use of a range of strategies to deal with the adverse effects.

The study elicited information that could help nursing staff understand how Thai people manage pain and the importance of cultural beliefs to their pain experience and coping strategies, which in turn can help nurses plan appropriate pain management.