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

Abstract

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, I² = 91%; 481 participants), and medium-term (1–3 m) (SMD: −0.29, 95% CI: −0.50 to −0.08, p = 0.01, I² = 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, I² = 65%; 711 participants) and medium-term (1–3 m) (SMD: −0.42, 95% CI: −0.76 to −0.09, p = 0.01, I² = 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, I² = 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.

Keywords:

• Maintenance hemodialysis
• psychoeducational interventions
• quality of life
• meta-analysis
• systematic review

Acknowledgements

Thanks to all the authors for their efforts in completing this systematic review.

Authors’ contributions

LY.Z. took part in the study design, literature research, assessments of research, data analysis and manuscript preparation. LZ took part in the study design, literature research, and research assessments. LJ.Z. was the guarantor of the integrity of the entire study and led the study design. All authors read and approved the final manuscript.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Data availability statement

The authors are willing to permanently share data supporting the results and analysis presented in the paper after publication. The data can be used for scientific research beneficial to human health. The datasets generated during and/or analyzed during the current study are available from the corresponding author on reasonable request.

Additional information

Funding

This work was supported by the Taizhou Science and Technology Project of Jiangsu Province, China, under Grant number TS202311.