Internet-based problem solving therapy improves depressive and dialysis related physical symptoms in hemodialysis patients under 65 years of age: A post-hoc secondary subgroup analysis of a cluster randomized controlled trial.
Patients on hemodialysis therapy often experience a high burden of mental and physical health symptoms. We developed a guided internet-based self-help problem-solving therapy (IPST) targeted on practical daily life issues. While we did not find an effect for all patients, we hypothesized that an int...
| Publicado en: | General Hospital Psychiatry Vol. 98; pp. 165 - 172 |
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| Autores principales: | , , , , , , , , , , , , , , , , |
| Formato: | research Journal Article |
| Publicado: |
Elsevier B.V.
Jan2026
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=190794019&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 190794019 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 01638343 JFH jtl: General Hospital Psychiatry issn: 01638343 maglogo: N pubinfo: dt: Jan2026 vid: 98 pid: 467 pub: Elsevier B.V. place: New York, New York artinfo: ui: 190794019 190794019 190794019 10.1016/j.genhosppsych.2025.12.022 190794019 ppf: 165 ppct: 7 formats: tig: atl: Internet-based problem solving therapy improves depressive and dialysis related physical symptoms in hemodialysis patients under 65 years of age: A post-hoc secondary subgroup analysis of a cluster randomized controlled trial. aug: au: Zittema, Debbie Schouten, Robbert W. Nadort, Els Boeschoten, Rosa E. Smets, Yves Shaw, Prataap Chandie Vleming, Louis Jean Dekker, Marijke J.E. Westerman, Michiel Hoogeveen, Ellen K. Bos, Willem J.W. Schouten, Marcel Farhat, Karima van Oppen, Patricia Dekker, Friedo W. Siegert, Carl E.H. Broekman, Birit F.P. affil: Department of Psychiatry, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands sug: subj: Internet Problem Solving Internet-Based Intervention Methods Depression Prevention and Control Hemodialysis Psychosocial Factors Anxiety Therapy Quality of Life Treatment Outcomes Human Male Female Secondary Analysis Post Hoc Analysis Dialysis Patients Psychosocial Factors Depression Therapy Psychotherapy Methods Cognitive Therapy Aged, 80 and Over Aged Descriptive Statistics Data Analysis Software Cluster Analysis Age Factors Netherlands Psychological Tests Aged, 80 & over Aged: 65+ years Male Female ab: Patients on hemodialysis therapy often experience a high burden of mental and physical health symptoms. We developed a guided internet-based self-help problem-solving therapy (IPST) targeted on practical daily life issues. While we did not find an effect for all patients, we hypothesized that an internet intervention might be effective in younger patients below 65 years of age. In this post-hoc secondary subgroup analysis we divided our study population based on age to study the effect of our intervention on depressive- and dialysis-related symptoms. Chronic hemodialysis patients with a depression score on the Beck Depression Inventory (BDI-II) of ≥10, were randomized into a five modules guided IPST or a care-as-usual control group. The study population was stratified by age (< 65 and ≥ 65 years). The primary outcome was depressive symptoms (BDI-II). Secondary outcomes were anxiety (BAI), health-related quality of life (HRQoL) and dialysis related symptoms (DSI). Analyses were performed using linear mixed models. 122 out of 190 randomized patients completed post-intervention measurements. In 25 younger patients (age < 65), a significant effect was found in reduction of BDI-II (−30 %, p = 0.04) and DSI (presence of symptoms: −27 %, p = 0.001; level of distress: −25 %, p = 0.03). No effect was seen on BAI or HRQoL. In the older population (n = 29), no effect of the intervention was found on any outcomes. An easy to implement guided IPST showed a clinically relevant decrease in depressive symptoms and dialysis related physical symptoms in hemodialysis patients aged below 65 years although results should be interpreted cautiously given the post-hoc design. Dutch Trial Register: Trial NL6648 (NTR6834) (prospectively registered 13th November 2017). • Patients on dialysis often experience a high burden of mental and physical health symptoms. • Because of multiple barriers in implementation of psychotherapy, we developed a guided internet-based psychotherapy. • This guided internet-based problem solving therapy (IPST) is a cognitive-behavioral therapy (CBT). • In this RCT the IPST was tested in a subpopulation of hemodialysis patients below 65 years. • A significant effect of IPST was seen with a decrease in both depressive and dialysis related symptoms. pubtype: Academic Journal doctype: research Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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