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Technology-assisted cognitive-behavioral therapy intervention for end-stage renal disease
Karen P Jakubowski1, Manisha Jhamb2, Jonathan Yabes3
1Department of Psychology, University of Pittsburgh, Pittsburgh, PA, USA.
Translational Behavioral Medicine
|May 28, 2019
Summary
Technology-assisted cognitive-behavioral therapy (CBT) is feasible for end-stage renal disease (ESRD) patients undergoing hemodialysis (HD). This pilot study found the intervention acceptable, with high adherence and minimal HD interference, though symptom changes were not statistically significant.
Area of Science:
- Nephrology
- Psychiatry
- Health Technology
Background:
- Technology-assisted cognitive-behavioral therapy (CBT) is used for chronic illness symptoms but not yet for end-stage renal disease (ESRD).
- Patients with ESRD undergoing hemodialysis (HD) often experience depression, pain, and fatigue.
Purpose of the Study:
- To pilot the feasibility and acceptability of technology-assisted CBT for ESRD patients on HD.
- To share design and implementation lessons.
- To provide preliminary data on symptom changes.
Main Methods:
- A single-center pilot feasibility study involving adult ESRD patients on HD with elevated depression, pain, or fatigue.
- Eight weekly 45-60 minute CBT sessions delivered via video-conference during HD.
- Symptom assessment at baseline and 3-month follow-up.
Main Results:
- Eight of 10 screened patients completed the intervention, demonstrating high adherence and satisfaction.
- Minimal interference with HD sessions was reported.
- No statistically significant changes in depression, fatigue, or pain were observed, but a small improvement in the SF-36 Physical Component score was noted, with 67% of patients with baseline pain reporting improvement.
Conclusions:
- Technology-assisted CBT is a feasible and acceptable intervention for ESRD patients on HD.
- The intervention requires minimal additional resources in the HD setting.
- Larger trials are necessary to confirm the impact on patient-reported outcomes.
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