Effects of dyadic psychoeducational interventions for haemodialysis patients and their family caregivers: a randomised controlled trial.

Abstract

Background: Haemodialysis may affect the changes in the patient's relationship with the family, and eventually cause some psychological distress to the patient and affect the health-related quality of life. This study examines the effectiveness of the dyadic psychoeducational intervention on patients' quality of life and psychosocial health, as well as caregiver burden and psychosocial outcomes among caregivers.

Methods: This is a parallel, two-arm, assessor-blind, randomised controlled trial with a repeated-measures design. A total of 80 haemodialysis dyads (patient and family caregivers) randomly assigned to the intervention group or control group with usual care (N = 40 dyads per group). The intervention included 4-week dyadic psychoeducational intervention. At before intervention (T₀), immediately after intervention (T₁), 1 month after intervention (T₂) and 3 months after intervention (T₃), patients' quality of life ana caregiver burden (primary outcomes), and other secondary outcomes (i.e., dyads' coping, depression and anxiety symptoms, and social support) were evaluated. Generalized Estimated Equation was used to test the intervention effect of the dyadic psychoeducation intervention, and intentional-to-treat analysis was used for all analyses.

Results: Effects of dyadic psychoeducational intervention: The result of adjusting the GEE model shows that dyadic psychoeducational intervention can effectively improve patients' quality of life (T₁: β = 8.51, p < 0.001; T₂: β = 9.03, p < 0.001; T₃: β = 8.82, p < 0.001), patients' anxiety (T₁: β = -2.35, p = 0.022; T₂: β = -2.84, p = 0.002; T₃: β = -2.85, p = 0.001) and caregivers' anxiety (T₂: β = -1.67, p = 0.012; T₃: β = -2.57, p = 0.004), patients' depression (T₂: β = -2.39, p = 0.017; T₃: β = -2.71, p = 0.006), caregiver burden (T₂: β = -6.95, p = 0.007; T₃: β = -6.34, p = 0.008), caregiver depression (T₂: β = -2.01, p = 0.015; T₃: β = -1.85, p = 0.015).

Conclusions: The dyadic psychoeducational intervention can improve the psychosocial outcomes of haemodialysis dyads. This intervention provides effective ways and measures for the relevant psychological education intervention and provides new ideas and evidence for clinical nursing research.

Trial registration: This study was retrospectively registered as a randomized controlled trial in the ClinicalTrials Registry. Registration Date: April 16, 2024.

Registration number: NCT06203730.