Psychological and Exercise Intervention Training for Hemodialysis Patients: A Pilot Study

Michael MX Cai, Sanjeev Beweja, Rachel Reilly, Amy Clements, Annette Kent, Nicholas F Taylor, Robert J MacGinley, Stephen G Holt, Lawrence P McMahon


Background: Patients with end stage kidney disease (ESKD) have a reduced health related quality of life (HRQoL). This pilot study examined the effect of a 6-month combined cognitive behavioral therapy (CBT) and muscle strength training program on hemodialysis patients.

Methods: The outcomes of interest included HRQoL as measured by Short-Form 36 version 2 (SF-36v2), cardiac depression scale, self-efficacy score, 6-minute walk distance (6MWD), physical activity and muscle strengths. Twenty-seven patients were recruited for intervention, but only eight completed the study.

Results: At baseline, participants who completed intervention (CI) had a higher role emotional score (P = 0.028), role physical score (P = 0.008) and self-efficacy score (P = 0.019), compared to the participants who dropped out (ID). At the end of intervention, CI had improvements in physical functioning scores (P = 0.040) and 6MWD (P = 0.018), whereas ID had a decline in their role emotional scores (P = 0.045).

Conclusions: The result of this study suggests that a combined CBT and physical training intervention can benefit hemodialysis patients, but non-adherence to therapy is common. Self-efficacy could play an important role in therapy adherence in the ESKD population.

World J Nephrol Urol. 2014;3(2):83-91


Quality of life; Depression; Renal failure; Hemodialysis; Cognitive behavioral therapy; Strength training; Self-efficacy

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