Document Type : Original Article
Authors
1 Department of English, School of Paramedical Sciences, Shiraz University of Medical Sciences, Shiraz, Iran, IJCBNM research Center, Nursing School, Shiraz University of Medical Sciences, Shiraz, Iran, Center for Interdisciplinary Research in Islamic Education and Health Sciences, Shiraz University of Medical Sciences, Shiraz, Iran,
2 Department of Education, Fasa University of Medical Sciences, Fasa, Iran,
3 Department of Health in Disasters and Emergencies, Health Human Resources Research Center, School of Management and Information Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
4 Clinical Education Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
5 Department of Clinical Psychology, Fasa University of Medical Sciences, Fasa, Iran
Abstract
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.
Keywords
- McGill RL, Bragg‑Gresham JL, He K, Lacson Jr. EK, Miskulin DC,
Saran R. Chronic disease burdens of incident US dialysis patients,
1996‑2015. Clin Nephrol 2020;93:1‑8.
2. Pei M, Aguiar R, Pagels AA, Heimbürger O, Stenvinkel P,
Bárány P, et al. Health‑related quality of life as predictor of
mortality in end‑stage renal disease patients: An observational
study. BMC Nephrology 2019;20:144.
3. Sas C. The psychosocial evaluation is an essential part of the
pretransplant workup for patients with end‑stage renal disease:
A social worker’s perspective. Health Soc Work 2019;44:208‑11.
4. Khan A, Khan AH, Adnan AS, Sulaiman SA, Mushtaq S. - Prevalence and predictors of depression among hemodialysis
patients: A prospective follow‑up study. BMC Public Health
2019;19:531.
5. Mosleh H, Alenezi M, Al Johani S, Alsani A, Fairaq G, Bedaiwi R.
Prevalence and factors of anxiety and depression in chronic kidney
disease patients undergoing hemodialysis: A cross‑sectional
single‑center study in Saudi Arabia. Cureus 2020;12:e6668.
6. Işık Ulusoy S, Kal Ö. Relationship among coping strategies, quality
of life, and anxiety and depressive disorders in hemodialysis
patients. Ther Apher Dial 2020;24:189‑96.
7. Baykan H, Yargic I. Depression, anxiety disorders, quality of
life and stress coping strategies in hemodialysis and continuous
ambulatory peritoneal dialysis patients. Klinik Psikofarmakoloji
Bülteni Bulletin Clin Psychopharmacol 2012;22:167‑76.
8. Hagemann PM, Martin LC, Neme CM. The effect of music
therapy on hemodialysis patients’ quality of life and depression
symptoms. J Bras Nefrol 2019;41:74‑82.
9. Farnam A. The effect of positive thinking training in enhancement
of quality and hope of life among the elderly. Positive Psychol
2016;2:75‑88.
10. Ahadi H, Asadzadeh H. Effectiveness of positive thinking skills
training on depression in female students. Iran J Educ Sociol
2019;2:90‑9.
11. Espahbodi F, Hosseini H, Mirzade MM, Shafaat AB. Effect of
psycho education on depression and anxiety symptoms in patients
on hemodialysis. Iran J Psychiatry Behav Sci 2015;9:e227.
12. Fereidouni Z, Sabet Sarvestani R, Hariri G, Kuhpaye SA,
Amirkhani M, Kalyani MN. Moving into action: The master key
to patient education. J Nurs Res 2019;27:1‑8.
13. Beiranvand M, Moghadam MK, Sabounchi R, Asadpour G,
Jahani N, Ghafuori A. Positive thinking training increases
tolerance levels of ambiguity and distress in men with hemophilia.
J Sports Sci 2019;7:88‑95.
14. Zandiyeh Z, Zare E, Hedayati B. The impact of group training
about parenting styles on maternal attitudes toward parenting
styles. J Educ Health Promot 2015;4:85.
15. Darvishi A, Otaghi M, Mami S. The effectiveness of spiritual
therapy on spiritual well‑being, self‑esteem and self‑efficacy in
patients on hemodialysis. J Relig Health 2020;59:277‑88.
16. Ahangarzadeh Rezaei S, Nematolahei A, Oladrostam N. The
effect of positive thinking training on stress, anxiety and
depression in coronary heart disease. J Urmia Nurs Midwifery
Fac 2017;15:339‑48
17. Shaghaghi F, Abedian Z, Forouhar M, Esmaily H, Eskandarnia E.
Effect of positive psychology interventions on psychological
well‑being of midwives: A randomized clinical trial. J Educ Health
Promot 2019;8:160.
18. McLean S, Dixit J. The power of positive thinking: A hidden
curriculum for precarious times. Adult Educ Q 2018;68:280‑96.
19. Lyubomirsky S, Layous K. How do simple positive activities
increase well‑being? Curr Dir Psychol Sci 2013;22:57‑62.
20. Ghazbanzadeh R, EsmaeiliShad B, Masoumifard M, Hatamipour K.
The effect of positive thinking group training on psychological
well‑being, positive meta‑emotion and couple relationship quality
in nurses. Iran J Psychiatr Nurs 2020;7:26‑34.
21. Beiranvand M, Moghadam MK, Sabounchi R, Delphan M,
Ghafuori A, Keramati Moghadam R. The effectiveness of positive
thinking training on self‑efficacy and emotion regulation in men
with hemophilia. Trends Med 2019;19:1‑5.
22. Nikmanesh Z, Zandvakili M. The effect of positive thinking
training on quality of life, depression, stress and anxiety in
delinquent juveniles. Psycologe J 2015;8:14‑21.
23. Ebrahimi H, Sadeghi M, Amanpour F, Dadgari A. Influence of
nutritional education on hemodialysis patients’ knowledge and
quality of life. Saudi J Kidney Dis Transpl 2016;27:250‑5.
24. Bunevicius A. Reliability and validity of the SF‑36 Health Survey
Questionnaire in patients with brain tumors: A cross‑sectional
study. Health Qual Life Outcomes 2017;15:92.
25. Ware JE Jr., Gandek B. Overview of the SF‑36 Health Survey and
the International Quality of Life Assessment (IQOLA) project.
J Clin Epidemiol 1998;51:903‑12.
26. McHorney CA, Ware JE Jr., Lu JF, Sherbourne CD. The MOS
36‑item Short‑Form Health Survey (SF‑36): III. Tests of data
quality, scaling assumptions, and reliability across diverse patient
groups. Med Care 1994;32:40‑66.
27. Ware JE, Snow KK, Konsinski MA, Gandek B. The Health Institute,
New England Medical Center. Boston, Massachusetts; 1993.
28. Rezaei S, Khaksari Z. Validity and reliability of short form health
survey questionnaire (SF‑36) for use in iranian patients with
traumatic brain injury (TBI). Iran J Neurosurg 2019;5:79‑92.
29. Asghari Moghaddam M, Faghehi S. Validity of the SF‑36 health
survey questionnaire in two iranian samples. Sci J Clin Psycho
Pers 2003;1:1‑10.
30. Ware JE Jr. SF‑36 health survey update. Spine (Phila Pa 1976)
2000;25:3130‑9.
31. Atapour A, Nasr S, Boroujeni AM, Taheri D, Dolatkhah S.
A comparison of the quality of life of the patients undergoing
hemodialysis versus peritoneal dialysis and its correlation to the
quality of dialysis. Saudi J Kidney Dis Transpl 2016;27:270‑80.
32. Lovibond PF, Lovibond SH. The structure of negative emotional
states: Comparison of the Depression Anxiety Stress Scales (DASS)
with the Beck Depression and Anxiety Inventories. Behav Res
Ther 1995;33:335‑43.
33. Sahebi A, Asghari MJ, Salari RS. Validation of depression anxiety
and stress scale (DASS‑21) for an Iranian population. Iran Psychol
2005;4:299‑313.
34. Dargahi S, Mohsen Zade F, Zahrakar K, Didehban M. Effect of
positive thinking training on psychological well‑being and marital
relationship quality of infertile couple. Middle East J Disabil Stud
2017;7:97.
35. Seligman ME. Positive psychology, positive prevention, and
positive therapy. Handb Posit Psycho 2002;2:3‑12.
36. Seligman ME, Ernst RM, Gillham J, Reivich K, Linkins M. Positive
education: Positive psychology and classroom interventions. Oxf
Rev Educ 2009;35:293‑311.
37. Douki HE, Elyasi F, Hasanzadeh R. Effectiveness of positive
thinking training on anxiety, depression and quality of life
of mothers of children with leukemia. J Nurs Midwifery Sci
2019;6:21.
38. Babanataj R, Mazdarani S, Hesamzadeh A, Gorji MH, Cherati JY.
Resilience training: Effects on occupational stress and resilience
of critical care nurses. Int J Nurs Pract 2019;25:e12697.
39. Moaser ZA. Effectivenes of positive thinking skills training on
hamedan students anxiety and happines. Spec J Psychol Manage
2016;2(3):72‑79.
40. Kazemi N, Rasoulzadeh V, Mohammadi ST. Effect of positive
thinking education on social anxiety and cognitive avoidance of
mothers of children with specific learning disabilities. Q J Child
Ment Health 2019;5:148‑58.
41. Mohammad‑Najar N, Khoshnevis E, Banisi P. Effectiveness of
positive thinking skills training on the hope and quality of life of
drug‑dependent people. Addict Health 2017;9:120‑8.
42. Mousavi E, Esmaeili A, Saless SS. The effect of positive thinking
on quality of life and resiliency of cancer patients. Razavi Int J
Med 2015;3:e27122.