Psychosocial interventions to improve outcomes among dialysis patients

Krespi, Margörit Rita

doi:10.1111/sdi.12638

Cited by 10 publications

(8 citation statements)

References 54 publications

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“…18 Patient education is based on the premise that knowledge is linked to change, and patients need relevant knowledge to make informed decisions about their health. 51 However, patient education alone may not be an effective intervention to produce behavior change in patients with ESKD, 52 and may be more successful if used in combination with behavioral strategies. Patients require training in how to self-regulate their exercise behavior, which could include how to develop personalized "action plans", that is planning, when, where, and how the exercise will occur, as well as skills to self-monitor their progress.…”

Section: Discussionmentioning

confidence: 99%

Barriers and facilitators for engagement and implementation of exercise in end‐stage kidney disease: Future theory‐based interventions using the Behavior Change Wheel

Clarke

Jhamb

Bennett

2019

Seminars in Dialysis

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Theory‐driven interventions are required to increase the adoption and implementation of physical activity and exercise programs among patients with ESKD. The Behavior Change Wheel (BCW) represents a synthesis of behavior change theories and can be used to aid the systematic development of theory‐driven interventions designed to change exercise behavior. The goal of this review was to synthesize barriers and facilitators to engagement and implementation of exercise and develop theory‐based recommendations for exercise behavior change interventions in patients with ESKD. We applied the BCW in the current context of exercise for ESKD patients and conducted an analysis of patients’ and health care professionals’ (HCPs) capabilities, opportunities, and motivations to engage or promote exercise, respectively. Our analysis identified a number of salient barriers that could be targeted via intervention to increase levels of physical activity and exercise. Intervention functions identified as most likely to change patient behavior included training, enablement, education, restructuring environment, persuasion, modeling, incentivizing, and coercion. Similarly, intervention functions most likely to change HCPs behavior for exercise promotion included training, modeling, education, environmental restructuring, persuasion, and incentivizing. We also considered potential over‐arching policy changes required to support these interventions. Our findings provide theory‐based recommendations that can help inform future clinical and research decision‐making for implementing exercise interventions in these patients. However, high‐quality research in this area is desperately needed to ensure that interventions not only be theory‐driven, but evidence‐based.

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Section: Discussionmentioning

confidence: 99%

Barriers and facilitators for engagement and implementation of exercise in end‐stage kidney disease: Future theory‐based interventions using the Behavior Change Wheel

Clarke

Jhamb

Bennett

2019

Seminars in Dialysis

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“…Imagery techniques can also target specific symptoms such as pain or medical procedures (e.g., dialysis treatment), and include suggestions to improve coping with such stressors . Although there are various approaches and terminology, mindfulness meditation generally involves individuals noticing, understanding, and integrating their perceptions of self and environment.…”

Section: Introductionmentioning

confidence: 99%

“…Although there are various approaches and terminology, mindfulness meditation generally involves individuals noticing, understanding, and integrating their perceptions of self and environment. This brings insight into people's thoughts, both positive or negative, and aids in observing, rather than reacting to, their thoughts and emotions …”

Section: Introductionmentioning

confidence: 99%

Improving wellbeing in patients undergoing dialysis: Can meditation help?

Bennett

Ngo

Kalife

et al. 2017

Seminars in Dialysis

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Coping with the stress and anxiety caused by end stage kidney disease (ESKD) symptoms, treatment, restrictions, and social, financial and family stressors, consumes many afflicted with kidney disease. Meditation has been shown to decrease anxiety and stress, and improve wellbeing and quality of life of people with chronic disease. However, the clinical uptake of meditation is low in the ESKD dialysis population. This review describes what meditation and mindful meditation are and how they have been used for people with ESKD. Further research, using active control conditions and larger sample size, is required to identify effective meditation interventions that can improve the wellbeing of our patients and their ability to cope with the demands of ESKD.

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“…ESRD poses a high burden of disease, causing physical and psychological harm [ 2 – 5 ]. Dialysis treatment, although life-saving, is often perceived as burdensome and negatively impacts quality of life (QOL); patients on chronic dialysis are at high risk of anxiety and depression [ 2 , 6 – 12 ]. Patients treated with dialysis are reported to be at high risk of malignant ventricular tachyarrhythmia, although reports in the literature likely overestimate sudden cardiac death incidence in this population [ 1 , 13 , 14 ].…”

Section: Introductionmentioning

confidence: 99%

The impact of transvenous cardioverter-defibrillator implantation on quality of life, depression and optimism in dialysis patients: report on the secondary outcome of QOL in the randomized controlled ICD2 trial

et al. 2021

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Rationale The impact of prophylactic implantable cardioverter-defibrillator (ICD) implantation on the psychological well-being of patients on dialysis is unknown. Objective We aimed to identify the effect of primary ICD implantation on quality of life (QoL), mood and dispositional optimism in patients undergoing dialysis. Methods and results We performed a prespecified subanalysis of the randomized controlled ICD2 trial. In total, 177 patients on chronic dialysis, with an age of 55–81 years, and a left ventricular ejection fraction of ≥ 35%, were included in the per-protocol analysis. Eighty patients received an ICD for primary prevention, and 91 patients received standard care. The Short Form-36 (SF-36), Geriatric Depression Scale-15 (GDS-15), Revised Life Orientation Test (LOT-R) questionnaires were administered prior to ICD implantation (T0), and at 1-year follow-up (T1) to assess QoL, depression and optimism, respectively. The patients were predominantly male (76.0%), with a median age of 67 years. Hemodialysis was the predominant mode of dialysis (70.2%). The GDS-15 score difference (T1 − T0) was 0.5 (2.1) in the ICD group compared with 0.3 (2.2) in the control group (mean difference − 0.3; 95% CI − 1.1 to 0.6; P = 0.58). The LOT-R score difference was − 0.2 (4.1) in the ICD group compared with − 1.5 (4.0) in the control group (mean difference − 1.1 (0.8); 95% CI − 2.6 to 0.4; P = 0.17). The mean difference scores of all subscales of the SF-36 were not significantly different between randomization groups. Conclusions In our population of patients on dialysis, ICD implantation did not affect QoL, mood or dispositional optimism significantly during 1-year follow-up. Clinical Trial Registration Unique identifier: ISRCTN20479861. http://www.controlled-trials.com.

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Psychosocial interventions to improve outcomes among dialysis patients

Cited by 10 publications

References 54 publications

Barriers and facilitators for engagement and implementation of exercise in end‐stage kidney disease: Future theory‐based interventions using the Behavior Change Wheel

Barriers and facilitators for engagement and implementation of exercise in end‐stage kidney disease: Future theory‐based interventions using the Behavior Change Wheel

Improving wellbeing in patients undergoing dialysis: Can meditation help?

The impact of transvenous cardioverter-defibrillator implantation on quality of life, depression and optimism in dialysis patients: report on the secondary outcome of QOL in the randomized controlled ICD2 trial

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