Improving Depression, Hope, and Quality of Life in Dialysis Patients Using Health Promotion Education Groups

Abstract

Taiwan has the highest incidence and prevalence of dialysis in the world. The literature suggests that severity of depression at the beginning of dialysis treatment is an independent predictor of survival. Depression significantly worsens the condition of chronic renal disease patients, with the adverse consequences of depression including increased mortality and hospitalization rates as well as poor compliance and quality of life. Given the importance of this problem, providing safe and effective information and good nursing care to dialysis patients is urgently needed. The purpose of this study was to explore the effects of implementing health promotion education groups on self-perceived depression, hope, and quality of life in dialysis patients. Dialysis patients who met the study criteria and had provided consent to participate in the health promotion education group were randomly assigned to either the treatment group (20 persons) or the control group (20 persons). In the control group, routine dialysis treatment and nursing care were maintained. In addition to receiving routine dialysis treatment and nursing care, the experimental group participated in health promotion education group activities for 90 minutes, twice a week for a total of 8 sessions. The quantitative data from both groups and the qualitative data analysis of the experimental group were used to assess the effects of the intervention. The results showed that the intervention had significantly improved self-perceived depression, hope, and quality of life in the experimental group. The participants indicated that the health promotion education group had helped them learn to adapt to their physical conditions, change their mindset, learn to regard happiness as the purpose of life, and maintain hope and increase mutual support in the face of difficulties. This study demonstrated that the cross-disciplinary integrated care provided through health promotion education groups is able to significantly improve depression, hope, and quality of life in dialysis patients. Thus, health promotion education groups arranged by the case management nurses for dialysis patients have the potential to promote mental health and quality of life in these patients. Therefore, continuing education is recommended to strengthen the awareness and knowledge of dialysis case management nurses with regard to applying integrated cross-disciplinary care in health promotion education groups and to promoting the implementation of these groups in the holistic care of dialysis patients.