Zahra Zulfa, Effendy Elmeida, Mawarpury Marty, Jaya Indra
Doctoral Program in Medical Sciences, Faculty of Medicine, Universitas Syiah Kuala, Banda Aceh, Indonesia.
Department of Psychiatry, Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia.
Narra J. 2023 Dec;3(3):e215. doi: 10.52225/narra.v3i3.215. Epub 2023 Oct 13.
Chronic kidney disease (CKD) patients, especially those with hemodialysis, frequently struggle with mental health issues like anxiety and depression. Psychotherapy has been known to treat psychological problems, but its effectiveness in managing CKD patients is still rarely scientifically proven. The aim of this study was to analyze the role of psychological treatments in improving the mental health of CKD patients with hemodialysis. We comprehensively reviewed the related studies published in PubMed, Google Scholar, ScienceDirect, and Clinical Key over the last ten years, up to June 7, 2023. A keyword combination was used in the search engine strategies, and all articles about CKD patients receiving hemodialysis and psychotherapy were included. Based on the eligibility criteria, 716 patients were included in 13 out of 18,830 studies in the final analysis. Psychological problem was complained by 399 CKD patients. The psychotherapy included cognitive behavioral therapy (reported in four studies, n=4), diaphragmatic breathing relaxation (n=1), meditation (n=1), hypnotherapy (n=1), Kidney Optimal Health Program (KOHP) (n=1), psychological intervention (n=1), murottal Al-Qur'an therapy (n=3), and spiritual therapy (n=1). These interventions were performed once to four times a week, for ten minutes to five hours during hemodialysis for two to ten weeks. Meditation and KOHP showed no significant improvement in anxiety and depression. The remaining psychotherapies significantly improved the quality of life by reducing anxiety and depression in hemodialysis patients and enhancing sleep quality, self-esteem, hopefulness, medication adherence, and physical condition. In conclusion, psychotherapy should be considered in an interdisciplinary team to treat CKD patients comprehensively. Further studies are still necessary to determine the efficacy of each psychological intervention in CKD patients with psychiatric problems.
慢性肾脏病（CKD）患者，尤其是那些接受血液透析的患者，经常与焦虑和抑郁等心理健康问题作斗争。心理治疗已知可治疗心理问题，但其在管理CKD患者方面的有效性仍很少得到科学证明。本研究的目的是分析心理治疗在改善接受血液透析的CKD患者心理健康方面的作用。我们全面回顾了过去十年（截至2023年6月7日）在PubMed、谷歌学术、ScienceDirect和Clinical Key上发表的相关研究。在搜索引擎策略中使用了关键词组合，所有关于接受血液透析和心理治疗的CKD患者的文章都被纳入。根据纳入标准，最终分析中18830项研究中的13项纳入了716例患者。399例CKD患者抱怨有心理问题。心理治疗包括认知行为疗法（四项研究报道，n = 4）、膈式呼吸放松法（n = 1）、冥想（n = 1）、催眠疗法（n = 1）、肾脏最佳健康计划（KOHP）（n = 1）、心理干预（n = 1）、《古兰经》诵读疗法（n = 3）和精神疗法（n = 1）。这些干预措施每周进行一至四次，在血液透析期间持续十分钟至五小时，为期两至十周。冥想和KOHP在焦虑和抑郁方面没有显示出显著改善。其余心理治疗通过降低血液透析患者的焦虑和抑郁、提高睡眠质量、自尊、希望、药物依从性和身体状况，显著改善了生活质量。总之，应在跨学科团队中考虑心理治疗，以全面治疗CKD患者。仍有必要进行进一步研究，以确定每种心理干预对有精神问题的CKD患者的疗效。
