Online positive psychology exercises improve quality of life in hemodialysis patients

October 10, 2018 by Sharita Forrest, University of Illinois at Urbana-Champaign
Hemodialysis patients who participated in an internet-based positive psychology program for five weeks significantly improved their depressive symptoms and ability to cope with their disease, according to a study led by University of Illinois researchers. The team included, from left:  graduate student Brett Burrows, kinesiology and community health professor Kenneth Wilund, social work professor Rosalba Hernandez and graduate student Shuo Xu. Credit: L. Brian Stauffer

Kidney dialysis patients who engage in technology-based positive psychology exercises during their treatments may significantly improve their depressive symptoms and quality of life, a new study found.

Patients with depression who used tablet computers to complete brief positive psychology exercises online several times a week scored lower on depressive symptoms and reported that they felt better able to cope with their by the end of the five-week pilot study, led by University of Illinois social work professor Rosalba Hernandez.

During their scheduled dialysis treatments, patients logged on to the study's website to watch videos, read material and complete exercises that promoted psychological well-being and resilience. The 20-30-minute modules explored topics such as identifying and building on one's personal strengths, cultivating gratitude and using positive reappraisal to reinterpret events.

On average, patients who completed the study visited the positive psychology website more than three times a week. In the first module each week, patients were introduced to a new skill and on subsequent days practiced that skill or made plans to incorporate it into their daily life.

"Hemodialysis patients are a vulnerable population with compromised health, and effective treatment of depressive symptoms can dramatically improve their quality of life, and reduce their morbidity and mortality," Hernandez said.

Studies have found that as many as one-third of kidney dialysis patients experience depression, which is associated with decreased adherence to prescription medications, poorer survival rates and a host of other negative outcomes. Comorbid depression considerably exacerbates kidney disease progression, increases systemic inflammation and compromises cellular immunity, according to the current study.

 Positive psychology interventions that promote attributes such as gratitude, optimism and emotional vitality have helped alleviate depressive symptoms in patients with other chronic illnesses, including heart disease, diabetes and HIV, according to Hernandez and her co-authors.

"In the past, medications have been the preferred treatment strategy for who experience depression," Hernandez said. "However, the typical dialysis patient in the U.S. is already taking as many as 12 prescription medications daily, so many health care providers and patients are reluctant to add yet another medication to their regimen and heighten their pill burden."

Of the 12 participants who completed the program, the majority said they found the exercises useful in helping them cope with their kidney disease. Participants' scores on the assessment decreased significantly at the end of the trial, while their scores on quality of life, emotional well-being, physical vigor and social interactions improved.

Patients in the current study, which was published recently by the journal Social Work in Health Care, had been attending dialysis treatment three times a week for more than three years on average when they participated in the intervention.

"Many patients experience boredom during their dialysis sessions, which can last up to four hours each," Hernandez said. "Patients are a captive audience during their dialysis sessions, so using a tablet computer to read the material on the website, watch the videos and participate in the exercises can help distract them from the monotony of and promote healthful adherence with the treatments."

Five of the eight prior clinical trials that explored the use of psychosocial interventions for hemodialysis patients with comorbid depression used cognitive behavioral therapy that was provided in face-to-face sessions with clinicians, according to the current study. However, behavioral health interventions delivered online or through mobile apps have been found to be as effective as traditional face-to-face therapy and can be accessible to larger numbers of users, according to Hernandez and her co-authors.

While the sample size in the current study was small, Hernandez said "the results offer preliminary evidence that psychosocial interventions are viable alternatives to the current overreliance on prescription drugs for hemodialysis patients. Our study confirms the feasibility and acceptability of an internet-based positive psychological intervention, which demonstrated significant improvements in ' depressive symptomatology over a five-week period."

Explore further: Depression is under-treated in patients receiving chronic dialysis

More information: Rosalba Hernandez et al. Feasibility of an Internet-based positive psychological intervention for hemodialysis patients with symptoms of depression, Social Work in Health Care (2018). DOI: 10.1080/00981389.2018.1523268

Related Stories

Depression is under-treated in patients receiving chronic dialysis

January 26, 2017
Many patients with kidney failure who are receiving chronic hemodialysis have depressive symptoms but do not wish to receive aggressive treatment to alleviate them, according to a study appearing in an upcoming issue of the ...

Certain factors linked with kidney function recovery in children on dialysis

September 20, 2018
Children with kidney failure due to certain diseases may regain kidney function and therefore no longer need dialysis, and kidney transplantation might be postponed. The findings, which appear in an upcoming issue of the ...

Depressive symptoms and pain may affect health outcomes in dialysis patients

July 31, 2014
Depressive symptoms and pain in patients on dialysis may have serious negative consequences for patients' health and increase the need for costly medical services, according to a study appearing in an upcoming issue of the ...

Home dialysis may be better than in-center hemodialysis for patients with kidney failure

November 15, 2014
Home dialysis therapies may help prolong the lives of patients with kidney failure compared with hemodialysis treatments administered in medical centers, according to a study that will be presented at ASN Kidney Week 2014 ...

Sertraline treatment no benefit for depressive symptoms in CKD

November 7, 2017
(HealthDay)—Sertraline treatment does not significantly improve depressive symptoms among patients with non-dialysis-dependent chronic kidney disease (CKD) and major depressive disorder (MDD), according to a study published ...

Exercise shown to improve symptoms of patients with chronic kidney disease

August 16, 2018
Just 12 weeks of aerobic and strength-based exercise reduces symptoms and levels of fatigue in patients with chronic kidney disease, a study in Leicester has found.

Recommended for you

New hope for cystic fibrosis

October 19, 2018
A new triple-combination drug treatment being trialled at the Mater Hospital in Brisbane could increase the life expectancy of patients with cystic fibrosis.

Suicide risk in abused teen girls linked to mother-daughter conflict

October 18, 2018
Teenage girls who were maltreated as children are more likely to entertain suicidal thoughts if the relationship with their mother is poor and the degree of conflict between the two of them high.

Bug guts shed light on Central America Chagas disease

October 18, 2018
In Central America, Chagas disease, or American trypanosomiasis, is spread by the "kissing bug" Triatoma dimidiata. By collecting DNA from the guts of these bugs, researchers reporting in PLOS Neglected Tropical Diseases ...

Rapid genomic sequencing of Lassa virus in Nigeria enabled real-time response to 2018 outbreak

October 18, 2018
Mounting a collaborative, real-time response to a Lassa fever outbreak in early 2018, doctors and scientists in Nigeria teamed up with researchers at Broad Institute of MIT and Harvard and colleagues to rapidly sequence the ...

Researchers cure drug-resistant infections without antibiotics

October 17, 2018
Biochemists, microbiologists, drug discovery experts and infectious disease doctors have teamed up in a new study that shows antibiotics are not always necessary to cure sepsis in mice. Instead of killing causative bacteria ...

Study shows how bias can influence people estimating the ages of other people

October 17, 2018
A trio of researchers from the University of New South Wales and Western Sydney University has discovered some of the factors involved when people make errors in estimating the ages of other people. In their paper published ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.