The effect of psychosocial interventions on depression, anxiety, and quality of life in hemodialysis patients: a systematic review and a meta-analysis

Barello, Serena; Anderson, Gloria; Acampora, Marta; Bosio, Caterina; Guida, Elena; Irace, Vincenzo; Guastoni, Carlo; Bertani, Barbara; Graffigna, Guendalina

doi:10.1007/s11255-022-03374-3

Cited by 11 publications

(5 citation statements)

References 62 publications

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“…For instance, interventions such as cognitive restructuring to modify illness perceptions [ 79 ] and reduce the impact of FOP [ 80 ], along with specialized health education materials that deepen patients’ understanding of their condition and treatment, can be effective [ 78 , 81 ]. Additionally, specialized psychosocial interventions [ 82 , 83 ], including psychotherapeutic Support, relaxation-based interventions, and group therapy sessions, can assist patients in reshaping their thought processes, alleviating anxiety about disease progression, and subsequently reducing the sense of social alienation.…”

Section: Discussionmentioning

confidence: 99%

Association between illness perception and social alienation among maintenance hemodialysis patients: The mediating role of fear of progression

Zhu,

Wu,

et al. 2024

PLoS ONE

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Purpose This study aimed to investigate the mediating role of fear of progression on illness perception and social alienation among maintenance hemodialysis (MHD) patients. Background MHD is frequently accompanied by increased pain and complications such as itchy skin, chronic fatigue, and muscle spasms. Cardiovascular disease rates are also elevated among MHD patients, which can heighten their anxiety regarding prognosis and treatment discomfort. This chronic fear may severely impact social functioning, leading patients to withdraw from interpersonal interactions and experience heightened helplessness and loneliness. Further investigation is necessary to understand the factors behind the high level of social alienation in MHD patients and their underlying mechanisms. Design A cross-sectional study guided by the STROBE. Methods A convenience sample of 230 MHD patients were enrolled from January to May 2023. Data including demographic and clinical characteristics, illness perception, fear of progression, and social alienation were collected. Descriptive analysis and Pearson correlations were conducted using IBM SPSS version 25.0. The mediating effect was analyzed using Model 4 of the PROCESS macro for SPSS, with the Bootstrap method employed to assess its significance. Results The score of social alienation in MHD patients was high, with illness perception and fear of progression both significantly correlated with social alienation. In the mediating effects model, illness perception can predict social alienation in MHD patients, and fear of progression use plays a part in mediating the process by which illness perception affects social alienation. The Kappa Squared (κ2) value of 21.9%, suggests a medium effect size. Conclusions Illness perception directly predicts social alienation in MHD patients and exerts an indirect effect through the mediating role of fear of progression. Suggests that healthcare professionals should concentrate on MHD patients with high negative illness perceptions to alleviate their fear of progression, thereby decreasing the level of social alienation and enhancing their integration into society.

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Section: Discussionmentioning

confidence: 99%

Association between illness perception and social alienation among maintenance hemodialysis patients: The mediating role of fear of progression

Zhu,

Wu,

et al. 2024

PLoS ONE

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“…There are reports of some randomised control trials that showed the efficacy of non-pharmacological treatment of depression, such as cognitive-based therapy and relaxation techniques, in the treatment of depression in CKD. [16,[106][107][108] Multidisciplinary team-based approach that includes mental health professionals will therefore be highly valuable in the management of CKD patients with depression.…”

Section: Discussionmentioning

confidence: 99%

Global Prevalence of Depression in Chronic Kidney Disease: A Systematic Review and Meta-Analysis

Adejumo,

Edeki,

Dapo

et al. 2023

Preprint

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BackgroundChronic kidney disease (CKD) is commonly associated with psychosocial problems, especially depression, contributing to poor overall outcomes in CKD patients. Depression has not been given adequate priority in the management of CKD despite its significant adverse impact.ObjectivesThis systematic review and meta-analysis determined the pooled prevalence of clinical depression in the global CKD population and sub-populations.DesignA systematic search of PubMed, African Journals Online (AJOL), and EMBASE was undertaken to identify published articles with relevant data between 1989 and 2022. The pooled prevalence of clinical depression in the global CKD population was determined using random effects meta-analytic techniques.ParticipantsGlobal adult and paediatric CKD populationResultsEligible Sixty-one articles were included in this review, comprising 79,691 CKD patients from 26 countries. The participants’ mean age ranged from 11.0 to 76.3 years. Most (68.9%) of the studies had medium methodological quality. The overall pooled prevalence of depression was 27.6% (95% CI: 23.9–31.5%). Studies using Diagnostic Statistical Manual (DSM), International Classification of Disease, Mini-International Neuropsychiatric Interview and Structured Clinical Interview for DSM disorder returned a pooled prevalence of 31.7%, 39.6%, 23.3%, 25.1%, respectively; p=0.09. There was significant difference in the pooled prevalence of CKD across the various continents; p=0.01.The prevalence of depression was higher among patients on chronic haemodialysis compared to those in pre-dialysis (31.1% versus 18.9%; p=0.02), and among those on hemodialysis compared to peritoneal dialysis (31.9% versus 20.4%; p=0.03). There was no significant difference between adults and children (28.0% versus 15.9%, p=0.17).ConclusionDepression is a common disorder in patients with CKD. The findings of this study have brought to the fore the need for clinicians to make deliberate efforts to evaluate CKD patients for depression, especially those with advanced stages of the disease.The study protocol was registered with PROSPERO (CRD42022382708)Strengths and LimitationsThe pooled prevalence of depression in this study correctly represents the magnitude of the depression in the CKD population because it included only studies where depression was diagnosed clinically.This review involved the global population of both adult and paediatric patients with pre-dialysis and dialytic kidney disease.Only a few studies in this review determined the prevalence of depression in the early stages of CKD.Studies reporting depression prevalence among kidney transplant patients were not included in this review, and the number of studies in the paediatric population was limited.

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“…Several previous reviews have summarized effective non-pharmacological interventions for improving health-related quality of life in patients undergoing maintenance hemodialysis, including psychosocial interventions, cognitive behavioral therapy interventions, physical exercise, and sensory training [ 20 – 24 ]. A recent systematic review and meta-analysis [25] showed that psychosocial interventions, which are any interventions used to modify behavior, emotional state, or feeling, could reduce anxiety (SMD − 0.99, 95%CI − 1.65 − 0.33, p < 0.01) and depression (SMD − 0.85, 95%CI − 1.17 − 0.52, p < 0.01) in adult hemodialysis patients, with some beneficial effects on quality of life. However, this review included studies that used randomized controlled trials (RCTs) or quasi-randomized controlled trials (quasi-experimental), which may limit analysis results, and these studies were not sufficiently specific in their scope of interventions and did not analyze and evaluate the characteristics of the interventions.…”

Section: Introductionmentioning

confidence: 99%

Effectiveness of psychoeducational interventions on psychological distress and health-related quality of life among patients with maintenance hemodialysis: a systematic review and meta-analysis

Zhang,

Zou,

Zhou

2024

Renal Failure

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Objective To examine the effectiveness of psychoeducational interventions on depression, anxiety, and health-related quality of life (HRQOL) for people undergoing maintenance hemodialysis (MHD). Methods This review used systematic review and meta-analysis as the research design. Nine databases, including PubMed, Web of Science, Embase, CINAHL Complete, Cochrane Library, CNKI, WanFang, VIP, and Chinese Biomedical Literature Database, were searched from the inception to the 8th of July 2023. Two reviewers independently identified randomized controlled trials (RCT) examining the effects of psychoeducational interventions on MHD patients. Results Fourteen studies involving 1134 MHD patients were included in this review. The results of meta-analyses showed that psychoeducational intervention had significant short-term (< 1 m) (SMD: −0.87, 95% CI: −1.54 to −0.20, p = 0.01, I 2 = 91%; 481 participants), and medium-term (1–3 m) (SMD: −0.29, 95% CI: −0.50 to −0.08, p = 0.01, I 2 = 49%; 358 participants) on anxiety in MHD patients, but the effects could not be sustained at longer follow-ups. Psychoeducational interventions can also have short-term (< 1 m) (SMD: −0.65, 95% CI: −0.91 to −0.38, p < 0.00001, I 2 = 65%; 711 participants) and medium-term (1–3 m) (SMD: −0.42, 95% CI: −0.76 to −0.09, p = 0.01, I 2 = 69%; 489 participants) effects in reducing depression levels in MHD patients. Psychoeducational interventions that use coping strategies, goal setting, and relaxation techniques could enhance the QOL in MHD patients in the short term (< 1 m) (SMD: 0.86, 95% CI: 0.42 to 1.30, p = 0.02, I 2 = 86%; 241 participants). Conclusions Psychoeducational interventions have shown great potential to improve anxiety, depression, and quality of life in patients with MHD at the short- and medium-term follow-ups. Trial registration number: CRD42023440561.

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The effect of psychosocial interventions on depression, anxiety, and quality of life in hemodialysis patients: a systematic review and a meta-analysis

Cited by 11 publications

References 62 publications

Association between illness perception and social alienation among maintenance hemodialysis patients: The mediating role of fear of progression

Association between illness perception and social alienation among maintenance hemodialysis patients: The mediating role of fear of progression

Global Prevalence of Depression in Chronic Kidney Disease: A Systematic Review and Meta-Analysis

Effectiveness of psychoeducational interventions on psychological distress and health-related quality of life among patients with maintenance hemodialysis: a systematic review and meta-analysis

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