Alishahi Moein, Mohajer Samira, Namazinia Mohammad, Mazloum Seyedreza
Master of Medical Surgical Nursing, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran.
Nursing and Midwifery Care Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.
Int Urol Nephrol. 2025 Feb;57(2):585-594. doi: 10.1007/s11255-024-04201-7. Epub 2024 Sep 11.
Chronic kidney disease is a progressive disorder often leading to End-stage renal disease, necessitating hemodialysis treatment. Mild depression is prevalent among hemodialysis patients, adversely affecting their quality of life. This study aimed to evaluate the effect of a smartphone-based recreational therapy intervention on mild depression in hemodialysis patients.
This randomized controlled trial was conducted at Montaserieh Hospital, Mashhad, Iran, involving 72 patients undergoing hemodialysis. Participants were randomly assigned to either the intervention group, receiving a custom-designed recreational therapy mobile app (including music, comedy, exercise, and educational content), or the control group, receiving standard care. The trial was registered with the Iranian Registry of Clinical Trials (IRCT20220803055608N1). Outcome assessors and statisticians were blinded to minimize bias. Sample size was calculated for an expected effect size of 0.90 with 80% power, resulting in 36 participants per group, adjusted for a 6% attrition rate. Depression levels were assessed using the Beck Depression Inventory-II (BDI-II) at baseline and after a 30-day intervention.
A total of 72 patients (36 per group) completed the analysis. The intervention group showed a significant decrease in depression scores compared to the control group (mean BDI-II score reduction: intervention group = 10.3 ± 4.1, control group = 4.6 ± 3.8; p < 0.001). Post-intervention, 86.1% of patients in the intervention group exhibited minimal depression (BDI-II score ≤ 13), compared to 61.1% in the control group (p = 0.005).
The smartphone-based recreational therapy intervention significantly reduced mild depression in hemodialysis patients. This approach can serve as a valuable complementary strategy to manage mild depression in this population. Further research is warranted to explore the long-term sustainability of these benefits and the intervention's impact on other patient-reported outcomes.
This study was registered in the Iranian Registry of Clinical Trials (no. IRCT20220803055608N1) on 28/08/2022.
慢性肾脏病是一种进行性疾病，常导致终末期肾病，需要进行血液透析治疗。轻度抑郁在血液透析患者中很普遍，对他们的生活质量产生不利影响。本研究旨在评估基于智能手机的娱乐疗法干预对血液透析患者轻度抑郁的影响。
这项随机对照试验在伊朗马什哈德的蒙塔塞里耶医院进行，纳入72例接受血液透析的患者。参与者被随机分配到干预组，接受定制的娱乐疗法移动应用程序（包括音乐、喜剧、锻炼和教育内容），或对照组，接受标准护理。该试验已在伊朗临床试验注册中心注册（IRCT20220803055608N1）。结果评估者和统计人员采用盲法以尽量减少偏倚。计算样本量时，预期效应量为0.90，检验效能为80%，每组36名参与者，并针对6%的损耗率进行了调整。在基线和30天干预后，使用贝克抑郁量表第二版（BDI-II）评估抑郁水平。
共有72例患者（每组36例）完成分析。与对照组相比，干预组的抑郁评分显著降低（BDI-II评分平均降低：干预组 = 10.3 ± 4.1，对照组 = 4.6 ± 3.8；p < 0.001）。干预后，干预组86.1%的患者表现为轻度抑郁（BDI-II评分≤13），而对照组为61.1%（p = 0.005）。
基于智能手机的娱乐疗法干预显著降低了血液透析患者的轻度抑郁。这种方法可作为管理该人群轻度抑郁的一种有价值的补充策略。有必要进一步研究以探讨这些益处的长期可持续性以及该干预对其他患者报告结局的影响。
本研究于2022年8月28日在伊朗临床试验注册中心注册（编号IRCT20220803055608N1）。
