Effect of positive thinking training on stress, anxiety, depression, and quality of life among hemodialysis patients: A randomized controlled clinical trial

Background: Given the relationship between positivity interventions and psychological problems, this study aimed to investigate the effect of positive thinking training on stress, anxiety, depression, and quality of life of hemodialysis patients.

Materials and methods: This is a quasi-experimental and interventional study conducted on 70 hemodialysis patients referred to Fasa hemodialysis centers, Iran, between April 2019 and October 2019. Patients were selected using a simple sampling method and randomly divided into control (n = 35) and intervention (n = 35) groups. The intervention group was trained on positive thinking skills in eight sessions of a workshop. Before and after the intervention, stress, anxiety, depression, and quality of life in both the groups were measured using the Depression, Anxiety, and Stress Scale-21 and Short Form-36 Questionnaire. Data were analyzed using paired t-test, independent t-test, Kolmogorov-Smirnov, and Chi-square tests.

Results: There was no significant difference in the mean scores of stress, anxiety, depression, and quality of life in the two groups before the intervention.(P > 0.05), and in the control group, there was no statistically significant difference before and after the intervention (P = 0.092, P = 0.228, 0.280, respectively). In the intervention group, the mean score of stress and anxiety decreased from 23.65 ± 4.12 to 16.68 ± 4.41 (P < 0.001) and from 17.77 ± 5.15 to 14.57 ± 4.18 (P = 0.002), respectively, and that of the patients' quality of life also increased from 35.19 ± 10.07 to 55.98 ± 11.71 (P < 0.001). However, the mean score of depression did not change significantly after the intervention (P = 0.689).

Conclusion: According to the results of this study, the use of positive thinking intervention programs with other methods for hemodialysis patients' care and treatment is recommended as a nonpharmacological, cost-effective, and uncomplicated method.