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Follow-Up Study on the Effect of Cognitive Behaviour Therapy on Haemodialysis Adherence: A randomised controlled

Blessy P Valsaraj1, Shripathy M Bhat2, Ravindra Prabhu3

  • 1Department of Community & Mental Health, College of Nursing, Sultan Qaboos University, Muscat, Oman.

Sultan Qaboos University Medical Journal
|March 29, 2021
PubMed

Insights

Cognitive Behaviour Therapy (CBT) significantly improved adherence to dialysis, fluid, drug, and diet regimens in chronic kidney disease (CKD) patients undergoing haemodialysis. CBT demonstrated superior outcomes compared to non-directive counselling.

Area of Science:

  • Nephrology
  • Psychology
  • Clinical Medicine

Background:

  • Patients with chronic kidney disease (CKD) undergoing haemodialysis frequently encounter psychosocial challenges impacting treatment adherence.
  • Poor adherence to therapeutic regimens exacerbates clinical complications in CKD patients.

Purpose of the Study:

  • To evaluate the efficacy of Cognitive Behaviour Therapy (CBT) in enhancing adherence to dialysis, fluid intake, medication, and diet.
  • To compare the impact of CBT versus non-directive counselling on adherence and clinical outcomes in haemodialysis patients.

Main Methods:

  • A randomized controlled trial involving 67 CKD patients undergoing haemodialysis in India.
  • The experimental group received CBT, while the control group received non-directive counselling over a six-month period.
  • Adherence was measured using a validated haemodialysis adherence scale; effect sizes were calculated using Cohen's d.

Main Results:

  • The CBT group showed significant reductions in interdialytic weight gain and blood pressure.
  • Significant improvements were observed in haemoglobin levels and adherence to dialysis, fluids, diet, and drugs in the CBT group.
  • These improvements were statistically significantly greater in the CBT group compared to the control group (P = 0.001).

Conclusions:

  • Cognitive Behaviour Therapy (CBT) is more effective than non-directive counselling for improving therapeutic adherence in CKD patients on haemodialysis.
  • CBT positively impacts physiological and clinical parameters, offering a valuable intervention for this patient population.
Abstract

Keywords:
Blood PressureChronic Kidney DiseaseCognitive Behavior TherapyHemodialysisHemoglobinPatient AdherenceRandomized Controlled TrialWeight Gain

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