Effectiveness of Wellbeing Intervention for Chronic Kidney Disease (WICKD): results of a randomised controlled trial.


Journal

BMC nephrology
ISSN: 1471-2369
Titre abrégé: BMC Nephrol
Pays: England
ID NLM: 100967793

Informations de publication

Date de publication:
19 04 2021
Historique:
received: 13 11 2020
accepted: 05 04 2021
entrez: 19 4 2021
pubmed: 20 4 2021
medline: 1 3 2022
Statut: epublish

Résumé

End stage kidney disease (ESKD) is associated with many losses, subsequently impacting mental wellbeing. Few studies have investigated the efficacy of psychosocial interventions for people with ESKD and none exist for Indigenous people, a population in which the ESKD burden is especially high. This three-arm, waitlist, single-blind randomised controlled trial examined efficacy of the Stay Strong App in improving psychological distress (Kessler distress scale; K10), depressive symptoms (adapted Patient Health Questionnaire; PHQ-9), quality of life (EuroQoL; EQ. 5D) and dialysis adherence among Indigenous Australians undergoing haemodialysis in central and northern Australia (Alice Springs and Darwin), with follow up over two 3-month periods. Effects of immediate AIMhi Stay Strong App treatment were compared with those from a contact control app (The Hep B Story) and treatment as usual (TAU). Control conditions received the Stay Strong intervention after 3 months. Primary analyses of the full sample (N = 156) showed statistically significant decreases in K10 and PHQ-9 scores at 3 months for the Hep B Story but not for the Stay Strong app or TAU. Restricting the sample to those with moderate to severe symptoms of distress or depression (K10 > =25 or PHQ-9 > =10) showed significant decreases in K10 and PHQ-9 scores for both Stay Strong and Hep B Story. No significant differences were observed for the EQ-5D or dialysis attendance. Findings suggest that talking to people about their wellbeing and providing information relevant to kidney health using culturally adapted, locally relevant apps improve the wellbeing of people on dialysis. Further research is required to replicate these findings and identify active intervention components. ACTRN12617000249358 ; 17/02/2017.

Sections du résumé

BACKGROUND
End stage kidney disease (ESKD) is associated with many losses, subsequently impacting mental wellbeing. Few studies have investigated the efficacy of psychosocial interventions for people with ESKD and none exist for Indigenous people, a population in which the ESKD burden is especially high.
METHODS
This three-arm, waitlist, single-blind randomised controlled trial examined efficacy of the Stay Strong App in improving psychological distress (Kessler distress scale; K10), depressive symptoms (adapted Patient Health Questionnaire; PHQ-9), quality of life (EuroQoL; EQ. 5D) and dialysis adherence among Indigenous Australians undergoing haemodialysis in central and northern Australia (Alice Springs and Darwin), with follow up over two 3-month periods. Effects of immediate AIMhi Stay Strong App treatment were compared with those from a contact control app (The Hep B Story) and treatment as usual (TAU). Control conditions received the Stay Strong intervention after 3 months.
RESULTS
Primary analyses of the full sample (N = 156) showed statistically significant decreases in K10 and PHQ-9 scores at 3 months for the Hep B Story but not for the Stay Strong app or TAU. Restricting the sample to those with moderate to severe symptoms of distress or depression (K10 > =25 or PHQ-9 > =10) showed significant decreases in K10 and PHQ-9 scores for both Stay Strong and Hep B Story. No significant differences were observed for the EQ-5D or dialysis attendance.
CONCLUSIONS
Findings suggest that talking to people about their wellbeing and providing information relevant to kidney health using culturally adapted, locally relevant apps improve the wellbeing of people on dialysis. Further research is required to replicate these findings and identify active intervention components.
TRIAL REGISTRATION
ACTRN12617000249358 ; 17/02/2017.

Identifiants

pubmed: 33866968
doi: 10.1186/s12882-021-02344-8
pii: 10.1186/s12882-021-02344-8
pmc: PMC8054368
doi:

Types de publication

Journal Article Randomized Controlled Trial Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

136

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Auteurs

Kylie M Dingwall (KM)

Menzies School of Health Research, Charles Darwin University, Alice Springs, NT, 0870, Australia. kylie.dingwall@menzies.edu.au.

Michelle Sweet (M)

Menzies School of Health Research, Charles Darwin University, Alice Springs, NT, 0870, Australia.

Alan Cass (A)

Menzies School of Health Research, Charles Darwin University, Darwin, NT, 0811, Australia.

Jaquelyne T Hughes (JT)

Menzies School of Health Research, Charles Darwin University, Darwin, NT, 0811, Australia.
Division of Medicine, Royal Darwin Hospital, Darwin, NT, 0811, Australia.
Department of Nephrology, Royal Darwin Hospital, Northern Territory Department of Health, Darwin, NT, 0810, Australia.

David Kavanagh (D)

Centre for Children's Health Research and School of Psychology & Counselling, Faculty of Health, Queensland University of Technology (QUT), Brisbane, QLD, 4101, Australia.

Kirsten Howard (K)

Sydney School of Public Health, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, 2006, Australia.

Federica Barzi (F)

Menzies School of Health Research, Charles Darwin University, Darwin, NT, 0811, Australia.

Sarah Brown (S)

Western Desert Nganampa Walytija Palyantjaku Tjutaku, Alice Springs, NT, 0870, Australia.

Cherian Sajiv (C)

Central Australian Renal Services, Alice Springs Hospital, Northern Territory Department of Health, Alice Springs, NT, 0870, Australia.

Sandawana W Majoni (SW)

Menzies School of Health Research, Charles Darwin University, Darwin, NT, 0811, Australia.
Department of Nephrology, Royal Darwin Hospital, Northern Territory Department of Health, Darwin, NT, 0810, Australia.
Northern Territory Medical Program, Flinders University, Darwin, NT, 0815, Australia.

Tricia Nagel (T)

Menzies School of Health Research, Charles Darwin University, Darwin, NT, 0811, Australia.

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