Educational or behavioural interventions for symptoms and health‐related quality of life in adults receiving haemodialysis: A systematic review

Abstract

SUMMARY Background People with end‐stage kidney disease (ESKD) suffer from multiple symptoms, which have a negative impact on their health‐related quality of life (HRQoL). Educational and behavioural interventions are being developed for this population; however, the effect of these interventions is unclear. Aim To evaluate the effectiveness of educational or behavioural interventions compared with standard care or alternative strategies on reducing symptoms and improving HRQoL in adults with ESKD receiving haemodialysis (HD). Methods An effectiveness systematic review using Joanna Briggs Institute (JBI) procedures was conducted on experimental studies [randomised controlled trials (RCTs), pseudo‐RCTs and quasi‐experimental designs] published in English between January 2009 and July 2019. Studies were retrieved from CINAHL, PubMed, MEDLINE, Embase, PsycINFO, Cochrane Library (Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trial) and JBI databases. Effect size at 95% confidence interval was calculated where possible. Results Eighteen studies involving 791 participants were included in this review. All studies involved behavioural interventions with the majority of studies (n = 11) targeting psychological symptoms. Interventions were categorised as either active or passive. Active interventions seemed to improve some physical symptoms, although there was very little evidence of improvements to HRQoL. Passive interventions tended to have a large effect on psychological symptoms and the mental health components of HRQoL. Conclusion Due to great heterogeneity between studies, meta‐analyses could not be conducted further limiting the evidence to inform practice. In addition, further research on educational interventions to teach self‐management strategies for symptom management and to improve HRQoL in people with ESKD receiving HD are needed.

Psychosocial Well-Being of Patients with Kidney Failure Receiving Haemodialysis during a Pandemic: A Survey

“…It has been long recognised that patients receiving HD experience reduced mental health and quality of life outcomes [29][30][31], yet little evidence currently exists relating to effective interventions [32]. Now more than ever, enhancing opportunities for psychosocial support is necessary to improve the mental health and well-being of those attending hospital HD.…”

The Role of Nephrology Nurses in Symptom Management – Reflections on the Kidney Disease: Improving Global Outcomes Controversies Conference on Symptom-Based Complications in Dialysis Care

“… 3 In some countries, roles of nephrology nurses include specialist and advanced practice, such as prescribing medications 4 and delivering nonpharmacologic interventions. 5 Despite some preliminary evaluation, a need exists to generate rigorous evidence to determine the best approach to nurse-led symptom control and support evidence-based practice of nephrology nurses.…”

Energy conservation education intervention for people with end-stage kidney disease receiving haemodialysis (EVEREST): protocol for a cluster randomised control trial

“…Despite fatigue being highly prevalent in those receiving HD, a recent systematic review did not find any interventional studies that used an educational approach for self-management to reduce symptoms and improve HRQoL in people undergoing HD. 37 Thus, this study aims to evaluate the effectiveness of an energy conservation education intervention for people with end-stage kidney disease receiving haemodialysis (EVEREST trial) in Nepal.…”