The effect of cognitive behavioural therapy on interdialytic weight gain in hemodialysis patients: A systematic review and meta-analysis

IF 1.6 4区医学 Q2 NURSING

Collegian Pub Date : 2025-04-30 DOI:10.1016/j.colegn.2025.04.002

Yeo Wool Kim , Gi Won Choi , Sun Ju Chang

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引用次数: 0

Abstract

Background

Interdialytic weight gain (IDWG) is a key indicator of fluid restriction adherence in hemodialysis patients and is associated with cardiovascular complications and higher mortality. Although cognitive behavioural therapy (CBT) has been used to reduce IDWG, its specific impact remains uncertain.

Aim

This study aimed to systematically review and evaluate the effects of CBT on IDWG in hemodialysis patients.

Methods

Relevant studies published from database inception to March 24, 2025, were searched across six electronic databases. Additionally, citation lists were searched. The selection of eligible studies followed a two-step process. Data were collected using a predefined form, and quality appraisal was conducted. Both narrative synthesis and meta-analysis were conducted.

Findings

Among 1418 retrieved studies, eight were selected in the narrative synthesis and seven in the meta-analysis. As a result of narrative synthesis, three studies delivered therapy during hemodialysis, with two using nurse providers. The contents focus on cognitive restructuring, behavioural activation, education, and social connections. The meta-analysis showed no significant effect immediately post-intervention and at three months post-intervention. However, a significant effect was observed at one month post-intervention.

Discussion

The structure and content of CBT sessions should be improved, with the format and providers adapted to meet the unique needs of hemodialysis patients. Additionally, rigorous studies are necessary to provide robust evidence.

Conclusion

CBT can reduce IDWG in hemodialysis patients. However, therapeutic effects may take time to manifest, and there may be challenges in sustaining these long-term effects.

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认知行为疗法对血液透析患者透析间期体重增加的影响：系统回顾和荟萃分析

背景：透析期间体重增加（IDWG）是血液透析患者液体限制依从性的关键指标，与心血管并发症和更高的死亡率相关。虽然认知行为疗法（CBT）已被用于减少IDWG，但其具体影响仍不确定。目的系统回顾和评价CBT对血液透析患者IDWG的影响。方法检索6个电子数据库自建库至2025年3月24日发表的相关研究。此外，检索了引文列表。选择符合条件的研究分为两步。使用预定义的表格收集数据，并进行质量评估。进行了叙事综合和元分析。结果：在1418项被检索的研究中，8项被选择用于叙事综合，7项被选择用于荟萃分析。作为叙述综合的结果，三项研究在血液透析期间提供治疗，其中两项使用护士提供者。内容集中于认知重构、行为激活、教育和社会联系。荟萃分析显示干预后立即和干预后3个月无显著效果。然而，在干预后一个月观察到显著的效果。讨论CBT课程的结构和内容应改进，形式和提供者应适应血液透析患者的独特需求。此外，严格的研究是必要的，以提供有力的证据。结论cbt可降低血液透析患者的IDWG。然而，治疗效果可能需要时间才能显现，而且维持这些长期效果可能存在挑战。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Collegian NURSING-

CiteScore

2.70

自引率

6.70%

发文量

127

审稿时长

72 days

期刊介绍： Collegian: The Australian Journal of Nursing Practice, Scholarship and Research is the official journal of Australian College of Nursing (ACN). The journal aims to reflect the broad interests of nurses and the nursing profession, and to challenge nurses on emerging areas of interest. It publishes research articles and scholarly discussion of nursing practice, policy and professional issues. Papers published in the journal are peer reviewed by a double blind process using reviewers who meet high standards of academic and clinical expertise. Invited papers that contribute to nursing knowledge and debate are published at the discretion of the Editor. The journal, online only from 2016, is available to members of ACN and also by separate subscription. ACN believes that each and every nurse in Australia should have the opportunity to grow their career through quality education, and further our profession through representation. ACN is the voice of influence, providing the nursing expertise and experience required when government and key stakeholders are deciding the future of health.