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Original Research

The Efficacy of a Nurse-Led Breathing Training Program in Reducing Depressive Symptoms in Patients on Hemodialysis

A Randomized Controlled Trial

Tsai, Siou-Hung, MSN, RN; Wang, Mei-Yeh, PhD, RN; Miao, Nae-Fang, PhD, RN; Chian, Pei-Chuan, MSN, RN; Chen, Tso-Hsiao, MD, PhD; Tsai, Pei-Shan, PhD, RN

AJN The American Journal of Nursing: April 2015 - Volume 115 - Issue 4 - p 24–32
doi: 10.1097/01.NAJ.0000463023.48226.16
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Background Depression is common in patients with chronic kidney disease who are on hemodialysis. Available behavioral modalities for treating depression may not be feasible for patients who receive hemodialysis two or three times per week.

Objectives The purpose of this randomized controlled trial was to examine the efficacy of a nurse-led, in-center breathing training program in reducing depressive symptoms and improving sleep quality and health-related quality of life in patients on maintenance hemodialysis.

Participants and methods Fifty-seven patients on hemodialysis were randomly assigned either to an eight-session breathing training group or to a control group. The Beck Depression Inventory II (BDI-II), the Pittsburgh Sleep Quality Index (PSQI), and the Medical Outcome Studies 36-Item Short Form Health Survey (SF-36) were used to assess self-reported depressive symptoms, sleep quality, and health-related quality of life, respectively.

Results The intervention group exhibited significantly greater decreases in BDI-II scores than the control group. No significant differences in PSQI change scores were observed between the groups. SF-36 change scores for both the domain of role limitation due to emotional problems and the mental component summary were significantly higher in the breathing training group than in the control group.

Conclusion This intervention significantly alleviated depressive symptoms, reduced perceived role limitation due to emotional problems, and improved the overall mental health component of quality of life in patients on maintenance hemodialysis.

This study reports on the efficacy of nurse-led deep-breathing exercises in improving the mental health and quality-of-life of patients on maintenance hemodialysis.

Siou-Hung Tsai is a nurse at Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan. Mei-Yeh Wang is an associate professor in the Department of Nursing at Cardinal Tien Junior College of Healthcare and Management in New Taipei City, Sindian District. Nae-Fang Miao is an assistant professor and Pei-Shan Tsai is a professor in the College of Nursing at Taipei Medical University, where Pei-Chuan Chian is a research assistant. Tso-Hsiao Chen is a physician in the nephrology division of the Department of Internal Medicine at Wan Fang Hospital. Authors S-H Tsai and M-Y Wang contributed equally to the research and writing of this article. Contact author: Pei-Shan Tsai, ptsai@tmu.edu.tw. The authors and planners have disclosed no potential conflicts of interest, financial or otherwise.

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