Abstract
This pilot study aimed to assess the feasibility, acceptability, and preliminary effects of a family-based psychoeducational intervention for patients undergoing hemodialysis (HD) and their family members. This was a single-group (six dyads), six-week, pre–post pilot study, delivered in a multifamily group format. Feasibility was based on screening, eligibility, content, retention, completion, and intervention adherence rates. Acceptability was assessed at post-intervention through a focus group interview. Self-reported anxiety and depression and patients’ inter-dialytic weight gain (IDWG) were also measured. The screening (93.5%), retention (85.7%), and completion (100%) rates were satisfactory, whereas eligibility (22.8%), consent (18.4%), and intervention adherence (range: 16.7–50%) rates were the most critical. Findings showed that participants appreciated the intervention and perceived several educational and emotional benefits. The results from the Wilcoxon Signed-Rank Test showed that a significant decrease in anxiety symptoms (p = 0.025, r = 0.646) was found, which was followed by medium to large within-group effect sizes for changes in depression symptoms (p = 0.261, r = 0.325) and patients’ IDWG (p = 0.248, r = 0.472), respectively. Overall, the results indicated that this family-based psychoeducational intervention is likely to be feasible, acceptable, and effective for patients undergoing HD and their family caregivers; nonetheless, further considerations are needed on how to make the intervention more practical and easily implemented in routine dialysis care before proceeding to large-scale trials.
Highlights
End-stage renal disease (ESRD) is a life-threatening condition in which the kidneys permanently fail to function, requiring patients to undergo some form of renal replacement therapy (RRT) to survive [1]
The findings revealed that patients on HD and their family members congruently expected that a familybased intervention would facilitate access to information about ESRD and hemodialysis demands, increase emotional support, improve coping skills and communication with healthcare professionals, and strengthen family involvement in the disease [41,42,43,44]
This study aimed to investigate the preliminary effectiveness of this family-based approach
Summary
End-stage renal disease (ESRD) is a life-threatening condition in which the kidneys permanently fail to function, requiring patients to undergo some form of renal replacement therapy (RRT) to survive [1]. The rate of psychiatric conditions, such as depression, in patients with ESRD is considerably higher than in populations with other chronic conditions such as cancer and congestive heart failure [9]. Depression in ESRD has been related to poor adherence [10]. It is well known that non-adherence to HD requirements can result in poor clinical outcomes (e.g., bone demineralization, clots in the access site, electrolyte imbalances, pulmonary congestion, heart failure) and decrease survival [11,12]
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