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KMID : 1102220180370010077
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Kidney Research and Clinical Practice
2018 Volume.37 No. 1 p.77 ~ p.84
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Effectiveness of group cognitive behavioral therapy with mindfulness in end-stage renal disease hemodialysis patients
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Sohn Bo-Kyung
Oh Yun-Kyu
Choi Jung-Seok
Song Ji-Youn
Lim Ah-Young
Lee Jung-Pyo
An Jung-Nam
Choi Hee-Jeong
Hwang Jae-Yeon
Jung Hee-Yeon
Lee Jun-Young
Lim Chun-Soo
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Abstract
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Background: Many patients with end-stage renal disease (ESRD) undergoing hemodialysis (HD) experience depression. Depression influences patient quality of life (QOL), dialysis compliance, and medical comorbidity. We developed and applied a group cognitive behavioral therapy (CBT) program including mindfulness meditation for ESRD patients undergoing HD, and measured changes in QOL, mood, anxiety, perceived stress, and biochemical markers.
Methods: We conducted group CBT over a 12-week period with seven ESRD patients undergoing HD and suffering from depression. QOL, mood, anxiety, and perceived stress were measured at baseline and at weeks 8 and 12 using the World Health Organization Quality of Life scale, abbreviated version (WHOQOL-BREF), the Beck Depression Inventory II (BDI-II), the Hamilton Rating Scale for Depression (HAM-D), the Beck Anxiety Inventory (BAI), and the Perceived Stress Scale (PSS). Biochemical markers were measured at baseline and after 12 weeks. The Temperament and Character Inventory was performed to assess patient characteristics before starting group CBT.
Results: The seven patients showed significant improvement in QOL, mood, anxiety, and perceived stress after 12 weeks of group CBT. WHOQOL-BREF and the self-rating scales, BDI-II and BAI, showed continuous improvement across the 12-week period. HAM-D scores showed significant improvement by week 8; PSS showed significant improvement after week 8. Serum creatinine levels also improved significantly following the 12 week period.
Conclusion: In this pilot study, a CBT program which included mindfulness meditation enhanced overall mental health and biochemical marker levels in ESRD patients undergoing HD.
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KEYWORD
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Cognitive behavioral therapy, Depression, Mindfulness, Quality of life, Renal dialysis
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