Hemodiyaliz Tedavisi Uygulanan Bireylerde Anksiyete ve Depresyonun Yönetiminde Nonfarmakolojik Yöntemlerin Rolü: Bir Literatür Derlemesi/ The Role of Non-pharmacological Methods in the Management of Anxiety and Depression in Individuals Undergoing Hemodialysis Treatment: A Literature Review

Abstract

Hemodiyaliz, kronik böbrek hastalığının tedavisinde sık uygulanan bir tedavi yöntemidir. Diyaliz tedavisindeki tıbbi ilerlemeler, hastaların uzun yıllar tedavi edilmesine olanak sağlasa da komorbid hastalıkların gelişmesini ve diyaliz tedavisinden kaynaklı semptomların görülmesini önleyememektedir. Hemodiyaliz tedavisi alan hastalar fiziksel semptomlar yaşadıkları gibi ekonomik, sosyal ve psikolojik sorunlarla da karşılaşabilmektedirler. Bu sorunlarından en önemlileri psikolojik olanlardır. Çünkü psikolojik sorunlar günlük yaşamda derin değişikliklere yol açabilmekte, depresyon ve anksiyeteye neden olmaktadır. Hemodiyaliz tedavisi alan hastalar, başta depresyon ve anksiyete olmak üzere çoklu duygusal ve psikolojik bozukluklardan etkilenebilmektedirler. Hemodiyaliz tedavisi hastaların çoğunda kısıtlılığa yol açarak günlük aktivitelerini yerine getirmelerinde sınırlılıklar oluşturmaktadır. Bu durum da stres, kaygı, anksiyete ve depresyona neden olmaktadır. Bu semptomlar hastaların yaşam kalitelerini azaltarak, daha uzun süre hastanede yatışa, sağlık bakım maliyetlerinde artışa ve erken mortaliteye sebep olmaktadır. Hemodiyaliz hastalarında semptom yönetiminde kullanılan farmakolojik yöntemlerin yanı sıra nonfarmakolojik tedavi yöntemleri de kullanılmaktadır. Nonfarmakolojik tedavi yöntemleri hastaların depresyon ve anksiyete düzeylerini azaltmakta ve yaşam kalitelerinin artmasına destek olmaktadır. Hemodiyaliz tedavisi alan hastaların depresyon ve anksiyete yönetiminde nonfarmakolojik tedavi yöntemlerinin uygulanması, etkinliğinin değerlendirilmesi ve bu konuda hem hastaların hem de sağlık personelinin cesaretlendirilerek bilgilendirilmesi ve farkındalığının arttırılması gerekmektedir. Bu derlemede, hemodiyaliz hastalarında görülen depresyon ve anksiyete yönetiminde nonfarmakolojik yöntemlerle ilgili bilimsel veriler incelenerek, elde edilen sonuçlar doğrultusunda önerilerde bulunulacaktır.

Keywords

• Hemodiyaliz
• Anksiyete
• Depresyon
• Nonfarmakolojik yöntemler

The Role of Non-pharmacological Methods in the Management of Anxiety and Depression in Individuals Undergoing Hemodialysis Treatment: A Literature Review

Abstract

Hemodialysis is a common treatment method in the treatment of chronic kidney disease. Although medical advances in dialysis treatment allow patients to be treated for many years, they cannot prevent the development of comorbid diseases and the development of symptoms resulting from dialysis treatment. Patients receiving hemodialysis treatment may experience physical symptoms as well as economic, social, and psychological problems. The most important of these problems are psychological problems. Because psychological problems can lead to profound changes in daily life, causing depression and anxiety. Patients receiving hemodialysis treatment may be affected by multiple emotional and psychological disorders, especially depression and anxiety. Hemodialysis treatment causes limitations in most of the patients and creates limitations in performing their daily activities. This causes stress, anxiety, anxiety and depression. These symptoms reduce the quality of life of patients and cause longer hospitalization, increase in health care costs and early mortality. In addition to pharmacological methods used in symptom management in hemodialysis patients, non-pharmacological treatment methods are also used. Non-pharmacological treatment methods reduce the depression and anxiety levels of the patients and support the increase in their quality of life. In the management of depression and anxiety in patients receiving hemodialysis treatment, non-pharmacological treatment methods should be applied, their effectiveness should be evaluated, and both patients and healthcare personnel should be encouraged and informed and awareness should be increased. In this review, scientific data on non-pharmacological methods in the management of depression and anxiety in hemodialysis patients will be examined and recommendations will be made in line with the results obtained.

Keywords

• Hemodialysis
• depression
• nonpharmacological methods
• anxiety

References

1. 1. Birol L, Çınar S. Böbrek Hastalıkları ve Hemşirelik Bakımı, N. Akdemir, ed. İç Hastalıkları ve Hemşirelik Bakımı. 6. Baskı, Ankara: Akademisyen Kitabevi; 2020. s:758-768.
2. 2. Sezen A. Diyaliz Hemşireliği. İstanbul: Nobel Tıp Kitabevleri; 2014. s:40-44.
3. 3. Kang GW, Lee IH, Ahn KS, Lee J, Ji Y, Woo J. Clinical and psychosocial factors predicting health-related quality of life in hemodialysis patients. Hemodial Int. 2015;19(3):439-446. DOI: 10.1111/hdi.12271
4. 4. Özdemir Ü, Taşcı S. Kronik hastalıklarda psikososyal sorunlar ve bakım. ERÜ Sağlık Bilimleri Fakültesi Dergisi. 2013;1: 57-72.
5. 5. Sarı Ö. Sosyal boyutlarıyla kronik böbrek yetmezliği. Bitlis Eren Üniversitesi Sosyal Bilimler Enstitüsü Dergisi. 2015; 4:72-80.
6. 6. Topbaş E, Bingöl G. Psikososyal boyutu ile diyaliz tedavisi ve uyum sürecine yönelik hemşirelik girişimleri. Nefroloji Hemşireliği Dergisi. 2017;12: 36-42.
7. 7. Goh ZS, Griva K. Anxiety and depression in patients with end-stage renal disease: impact and management challenges - a narrative review. Int J Nephrol Renovasc Dis. 2018;11:93-102. DOI: 10.2147/IJNRD.S126615
8. 8. Ravaghi H, Behzadifar M, Behzadifar M, Taheri Mirghaed M, Aryankhesal A, Salemi M, et al. Prevalence of Depression in Hemodialysis Patients in Iran: a Systematic Review and Meta-analysis. Iran J Kidney Dis. 2017;11(2):90-98.

9. 9. Gerogianni S, Babatsikou F, Gerogianni G, Grapsa E, Vasilopoulos G, Zyga S. et al Concerns of patients on dialysis: a research study. Health Sci J. 2014: 8(4):423–437.
10. 10. Fan L, Sarnak MJ, Tighiouart H, Drew DA, Kantor AL, Lou KV, et al. Depression and all-cause mortality in hemodialysis patients. Am J Nephrol. 2014;40(1):12-18. DOI: 10.1159/000363539
11. 11. Kargar Jahromi M, Javadpour S, Taheri L, Poorgholami F. Effect of Nurse-Led Telephone Follow ups (Tele-Nursing) on depression, anxiety and stress in hemodialysis patients. Glob J Health Sci. 2015;8(3):168-173 DOI: 10.5539/gjhs.v8n3p168
12. 12. Vasilopoulou C, Bourtsi E, Giaple S, Koutelekos I, Theofilou P, Polikandrioti M. The ımpact of anxiety and depression on the quality of life of hemodialysis patients. Glob J Health Sci. 2015;8(1):45-55. DOI: 10.5539/gjhs.v8n1p45
13. 13. Ng HJ, Tan WJ, Mooppil N, Newman S, Griva K. Prevalence and patterns of depression and anxiety in hemodialysis patients: a 12-month prospective study on incident and prevalent populations. Br J Health Psychol. 2015;20(2):374-395. DOI: 10.1111/bjhp.12106
14. 14. Chilcot J, Norton S, Wellsted D, Davenport A, Firth J, Farrington K. Distinct depression symptom trajectories over the first year of dialysis: associations with illness perceptions. Ann Behav Med. 2013;45(1):78-88. DOI: 10.1007/s12160-012-9410-5
15. 15. Cantekin I, Tan M. The influence of music therapy on perceived stressors and anxiety levels of hemodialysis patients. Ren Fail. 2013; 35(1): 105-9.
16. 16. Kim Y, Evangelista LS, Park YG. Anxiolytic effects of music interventions in patients receiving incenter hemodialysis: A systematic review and meta-analysis. Nephrology Nursing Journal, 2015;42:339-347.
17. 17. Nabolsi MM, Wardam L, Al-Halabi JO. Quality of life, depression, adherence to treatment and illness perception of patients on haemodialysis. Int J Nurs Pract. 2015;21(1):1-10. DOI: 10.1111/ijn.12205
18. 18. Baumeister H, Härter M. Mental disorders in patients with obesity in comparison with healthy probands. Int J Obes (Lond). 2007;31(7):1155-1164. DOI: 10.1038/sj.ijo.0803556
19. 19. Yavuz D, Yavuz R, Altunoğlu A. Hemodiyaliz hastalarında görülen psikiyatrik hastalıklar. Turkish Medical Journal. 2012;6(1):33-37.
20. 20. Gerogianni G, Lianos E, Kouzoupis A, Polikandrioti M, Grapsa E. The role of socio-demographic factors in depression and anxiety of patients on hemodialysis: an observational cross-sectional study. Int Urol Nephrol. 2018;50(1):143-154. DOI: 10.1007/s11255-017-1738-0
21. 21. Xing L, Chen R, Diao Y, Qian J, You C, Jiang X. Do psychological interventions reduce depression in hemodialysis patients?: A meta-analysis of randomized controlled trials following PRISMA. Medicine (Baltimore). 2016;95(34):e4675. DOI: 10.1097/MD.0000000000004675
22. 22. Clarke AL, Yates T, Smith AC, Chilcot J. Patient's perceptions of chronic kidney disease and their association with psychosocial and clinical outcomes: a narrative review. Clin Kidney J. 2016;9(3):494-502. DOI: 10.1093/ckj/sfw014
23. 23. Rezaei J, Abdi A, Rezaei M, Heydarnezhadian J, Jalali R. Effect of regular exercise program on depression in hemodialysis patients. Int Sch Res. 2015; 182030. DOI: 10.1155/2015/182030
24. 24. Grigoriou SS, Karatzaferi C, Sakkas GK. Pharmacological and Non-pharmacological treatment options for depression and depressive symptoms in hemodialysis patients. Health Psychol Res. 2015;3(1):1811. DOI: 10.4081/hpr.2015.1811
25. 25. Duarte PS, Miyazaki MC, Blay SL, Sesso R. Cognitive-behavioral group therapy is an effective treatment for major depression in hemodialysis patients. Kidney Int. 2009;76(4):414-421. DOI: 10.1038/ki.2009.156
26. 26. Cukor D, Ver Halen N, Asher DR, Coplan JD, Weedon J, Wyka KE, et al. Psychosocial intervention improves depression, quality of life, and fluid adherence in hemodialysis. J Am Soc Nephrol. 2014;25(1):196-206. DOI: 10.1681/ASN.2012111134
27. 27. Wolgensinger L. Cognitive behavioral group therapy for anxiety: recent developments. Dialog Clin Neurosci 2015;17:347–351.
28. 28. Chen HY, Cheng IC, Pan YJ, Chiu YL, Hsu SP, Pai MF, et al. Cognitive-behavioral therapy for sleep disturbance decreases inflammatory cytokines and oxidative stress in hemodialysis patients. Kidney Int. 2011;80(4):415-422. DOI: 10.1038/ki.2011.151
29. 29. Zhang M, Kim JC, Li Y, Shapiro BB, Porszasz J, Bross R, et al. Relation between anxiety, depression, and physical activity and performance in maintenance hemodialysis patients. J Ren Nutr. 2014;24(4):252-260. DOI: 10.1053/j.jrn.2014.03.002
30. 30. Ng CZ, Tang SC, Chan M, Tran BX, Ho CS, Tam WW, et al. A systematic review and meta-analysis of randomized controlled trials of cognitive behavioral therapy for hemodialysis patients with depression. J Psychosom Res. 2019;126:109834. DOI: 10.1016/j.jpsychores.2019.109834.
31. 31. Ling C, Evans D, Zhang Y, Luo J, Hu Y, Ouyang Y, et al. The effects of cognitive behavioural therapy on depression and quality of life in patients with maintenance haemodialysis: a systematic review. BMC Psychiatry. 2020;20(1):369. DOI: 10.1186/s12888-020-02754-2.
32. 32. Zegarow P, Manczak M, Rysz J, Olszewski R. The influence of cognitive-behavioral therapy on depression in dialysis patients - meta-analysis. Arch Med Sci. 2020;16(6):1271-1278. DOI: 10.5114/aoms.2019.88019.
33. 33. Chiang H, Livneh H, Yen M, Li T, Tsai T. Prevalence and correlates of depression among chronic kidney disease patients in Taiwan. BMC Nephrol 2013; 14:78.
34. 34. Dziubek W, Kowalska J, Kusztal M, Rogowski Ł, Gołębiowski T, Nikifur M, et al. The level of anxiety and depression in dialysis patients undertaking regular physical exercise training--a preliminary study. Kidney Blood Press Res. 2016;41(1):86-98. DOI: 10.1159/000368548
35. 35. Lopes AA, Lantz B, Morgenstern H, Wang M, Bieber BA, Gillespie BW, et al. Associations of self-reported physical activity types and levels with quality of life, depression symptoms, and mortality in hemodialysis patients: the DOPPS. Clin J Am Soc Nephrol. 2014;9(10):1702-1712. DOI: 10.2215/CJN.12371213
36. 36. R hee SY, Song JK, Hong SC, Choi JW, Jeon HJ, Shin DH, et al. Intradialytic exercise improves physical function and reduces intradialytic hypotension and depression in hemodialysis patients. Korean J Intern Med. 2019;34(3):588-598. DOI: 10.3904/kjim.2017.020
37. 37. Kouidi E, Karagiannis V, Grekas D, Iakovides A, Kaprinis G, Tourkantonis A, et al. Depression, heart rate variability, and exercise training in dialysis patients. Eur J Cardiovasc Prev Rehabil. 2010;17(2):160-167. DOI: 10.1097/HJR.0b013e32833188c4
38. 38. Huang M, Lv A, Wang J, Xu N, Ma G, Zhai Z, et al. Exercise training and outcomes in hemodialysis patients: systematic review and meta-analysis. Am J Nephrol. 2019;50(4):240-254. DOI: 10.1159/000502447
39. 39. Villanego F, Naranjo J, Vigara LA, Cazorla JM, Montero ME, García T, et al. Impact of physical exercise in patients with chronic kidney disease: Sistematic review and meta-analysis. Impacto del ejercicio físico en pacientes con enfermedad renal crónica: revisión sistemática metaanálisis. Nefrologia(Engl-Ed). 2020;40(3):237-252. DOI: 10.1016/j.nefro.2020.01.002
40. 40. Pei G, Tang Y, Tan L, Tan J, Ge L, Qin W. Aerobic exercise in adults with chronic kidney disease (CKD): a meta-analysis. Int Urol Nephrol. 2019;51(10):1787-1795. DOI: 10.1007/s11255-019-02234-x
41. 41. Carayanni V, Stylianopoulou C, Koulierakis G, Babatsikou F, Koutis C. Sex differences in depression among older adults: are older women more vulnerable than men in social risk factors? The case of open care centers for older people in Greece. Eur J Ageing. 2012;9(2):177-186. DOI: 10.1007/s10433-012-0216-x
42. 42. Perales Montilla CM, Duschek S, Reyes Del Paso GA. Quality of life related to health chronic kidney disease: Predictive importance of mood and somatic symptoms. Calidad de vida relacionada con la salud en la enfermedad renal crónica: relevancia predictiva del estado de ánimo y la sintomatología somática. Nefrologia. 2016;36(3):275-282. DOI: 10.1016/j.nefro.2015.12.002
43. 43. Lilympaki I, Makri A, Vlantousi K, Koutelekos I, Babatsikou F, Polikandrioti M. Effect of perceıved socıal support on the levels of anxıety and depressıon of hemodıalysıs patients. Mater Sociomed. 2016;28(5):361-365. DOI: 10.5455/msm.2016.28.361-365
44. 44. Lucchetti G, Almeida LG, Granero AL. Spirituality for dialysis patients: should the nephrologist address?. J Bras Nefrol. 2010;32(1):126-130.
45. 45. Santos PR, Capote Júnior JRFG, Cavalcante Filho JRM, Ferreira TP, Dos Santos Filho JNG, et al. Religious coping methods predict depression and quality of life among end-stage renal disease patients undergoing hemodialysis: a cross-sectional study. BMC Nephrol. 2017;18(1):197. DOI: 10.1186/s12882-017-0619-1
46. 46. Pazar B, Taştan S, İyigün E. Telesağlık sisteminde hemşirenin rolü. Bakırköy Tıp Dergisi. 2015;11(1): 1-4.
47. 47. Öztaş P, Şeker N, Taşkıntuna N. Kronik böbrek yetmezliği olan hastalarda grup terapisi süreci. Nöropsikiyatri Arşivi, 2012;49: 63-7. DOI: 10.4274/npa.y5990.
48. 48. Sohn BK, Oh YK, Choi JS, Song J, Lim A, Lee JP, et al. Effectiveness of group cognitive behavioral therapy with mindfulness in end-stage renal disease hemodialysis patients. Kidney Res Clin Pract. 2018;37(1):77-84. DOI: 10.23876/j.krcp.2018.37.1.77
49. 49. Gerogianni G, Babatsikou F, Polikandrioti M, Grapsa E. Management of anxiety and depression in haemodialysis patients: the role of non-pharmacological methods. Int Urol Nephrol. 2019;51(1):113-118. DOI: 10.1007/s11255-018-2022-7.
50. 50. Meawad EB, Mounir Radwan EH, Ahmed Elashri NIE, El-Gilany AH. The Effect of Benson’s Relaxation Technique on Anxiety, Depression and Sleep Quality of Elderly Patients Undergoing Hemodialysis. ijnd 2019, 9, 23-31.
51. 51. Kiani F, Zadeh MAH, Shahrakipour M. The effect of Benson’s relaxation method on hemodialysis patients’ anxiety. Biomedical Research (India), 2017; 28(3), 1075-1080.
52. 52. Thomas Z, Novak M, Platas SGT, et al. Brief mindfulness meditation for depression and anxiety symptoms in patients undergoing hemodialysis: A pilot feasibility study. Clin J Am Soc Nephrol. 2017;12(12):2008-2015. DOI: 10.2215/CJN.03900417
53. 53. Cho IH, Suh SR, Jang, KH. Stress coping resources of hemodialysis patients: mindfulness. Int J Adv Nurs Educ Res, 2017;1(1):149e54. DOI: 10.21742/ijaner.2017.2.1.26.
54. 54. Cantekin I, Tan M. The influence of music therapy on perceived stressors and anxiety levels of hemodialysis patients. Ren Fail, 2013;35(1): 105-9.
55. 55. Ovayolu N, Ovayolu Ö, Güngörmüş Z, Karadağ G. Böbrek Yetmezliğinde Tamamlayıcı Tedaviler, Nefroloji Hemşireliği Dergisi, 2015; s.40-46.
56. 56. Burrai F, Micheluzzi V, Zito MP, Pietro G, Sisti D. Effects of live saxophone music on physiological parameters, pain, mood and itching levels in patients undergoing haemodialysis. J Ren Care. 2014;40(4):249-256. DOI: 10.1111/jorc.12078
57. 57. Gültekin E. Ethical ıssues in aromatherapy courses in Turkey, Tur¬kiye Klin. J. Med. Ethics-Law Hist, 2020;28: 273–278.
58. 58. Cooke B, Ernst E. Aromatherapy: A systematic review. Brit J Gen Pract, 2020; 50 (455): 493-496.
59. 59. Itai T, Amayasu H, Kuribayashi M, Kawamura N, Okada M, Momose A, et al. Psychological effects of aromatherapy on chronic hemodialysis patients. Psychiatry Clin Neurosci. 2000;54(4):393-397. DOI: 10.1046/j.1440-1819.2000.00727.x
60. 60. Yazdani M, Esmaeilzadeh M, Pahlavanzadeh S, Khaledi F. The effect of laughter Yoga on general health among nursing students. Iran J Nurs Midwifery Res. 2014;19(1):36-40.
61. 61. Kataria M. Laughter yoga: Daily laughter practices for health and happiness. India: Penguin Random House India Private Limited, 2018.
62. 62. Ovayolu Ö, Ovayolu N. Semptom yönetiminde kanıt temelli tamamlayıcı yöntemler. Erciyes Üniversitesi Sağlık Bilimleri Fakültesi Dergisi. 2013;1(1): 83-98.
63. 63. Untas A, Chauveau P, Dupré-Goudable C, Kolko A, Lakdja F, Cazenave N. The effects of hypnosis on anxiety, depression, fatigue, and sleepiness in people undergoing hemodialysis: a clinical report. Int J Clin Exp Hypn. 2013;61(4):475-483. DOI: 10.1080/00207144.2013.810485