Hostname: page-component-cd9895bd7-jn8rn Total loading time: 0 Render date: 2024-12-25T08:12:20.090Z Has data issue: false hasContentIssue false
  • English
  • Français

Cognitive behavioural group therapy for insomnia (CBGT-I) in patients undergoing haemodialysis: a randomized clinical trial

Published online by Cambridge University Press:  16 September 2022

Hossein Shareh Open the ORCID record for Hossein Shareh [Opens in a new window] ,
Morteza Hasheminik Open the ORCID record for Morteza Hasheminik [Opens in a new window]  and
Mehdi Jamalinik Open the ORCID record for Mehdi Jamalinik [Opens in a new window]
Hossein Shareh*
Affiliation:
Department of Educational Science, Hakim Sabzevari University, Iran
Morteza Hasheminik
Affiliation:
Department of Nursing, Sabzevar Branch, Islamic Azad University, Iran
Mehdi Jamalinik
Affiliation:
Department of Nursing, Tabas Branch, Islamic Azad University, Iran
*
*Corresponding author. Email: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

Background:

Given the many complications of drug therapy, it seems reasonable to use non-pharmacological therapies that can improve mental and physical disorders in haemodialysis patients.

Aims:

This study aims to determine the effectiveness of cognitive behavioural group therapy for insomnia (CBGT-I) in sleep quality, depression, anxiety and general psychological health of haemodialysis patients.

Method:

This randomized clinical trial was conducted on 116 haemodialysis patients who were randomly assigned to experimental (n=58) and control (n=58) groups. In the experimental group, CBGT-I was provided during nine weekly sessions. Data collection tools included Pittsburgh Sleep Quality Index (PSQI), Beck Depression Inventory-II (BDIII), Beck Anxiety Inventory (BAI), General Health Questionnaire (GHQ-28), Clinical Global Improvement Scale (CGI), Client Satisfaction Questionnaire (CSQ) and Working Alliance Inventory-Short Form (WAI-S). Data were analysed by SPSS-25 and p<.05 was considered significant.

Results:

The findings demonstrated that CBGT-I compared with control group was effective in improving sleep quality (p<.001, η2=.790), depression (p<.001, η2=.616), anxiety (p<.001, η2=.682) and general psychological health (p<.001, η2=.871). Participants of CBGT-I showed notable improvements as a result of the treatment, were satisfied with treatment, and had a good therapeutic relationship.

Conclusions:

CBGT-I is effective in reducing depression and anxiety in addition to improving sleep quality and general psychological health in haemodialysis patients. Therefore, it is recommended to be used as a complementary treatment for these patients.

Keywords

cognitive behavioural group therapy for insomniadepressionkidney failuremental health
Type
Empirically Grounded Clinical Interventions
Information
Behavioural and Cognitive Psychotherapy , Volume 50 , Issue 6 , November 2022 , pp. 559 - 574
Copyright
© The Author(s), 2022. Published by Cambridge University Press on behalf of the British Association for Behavioural and Cognitive Psychotherapies

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Afkham-Ebrahimi, A., Rasoulian, M., Taherifar, Z., & Zare, M. (2010). The impact of anxiety on sleep quality. Medical Journal of the Islamic Republic of Iran, 23, 184–188. http://mjiri.iums.ac.ir/article-1-114-en.html Google Scholar
Anwar, N., & Mahmud, S. N. (2018). Quality of sleep in CKD patients on chronic hemodialysis and the effect of dialysis shift. Journal of the College of Physicians and Surgeons-Pakistan: JCPSP, 28, 636–639. https://doi.org/10.29271/jcpsp.2018.08.636 CrossRefGoogle ScholarPubMed
Ardito, R. B., & Rabellino, D. (2011). Therapeutic alliance and outcome of psychotherapy: historical excursus, measurements, and prospects for research. Frontiers in Psychology, 18, 270. https://doi.org/10.3389/fpsyg.2011.00270 Google Scholar
Attkisson, C. C., & Zwick, R. (1982). The Client Satisfaction Questionnaire. Psychometric properties and correlations with service utilization and psychotherapy outcome. Evaluation and Program Planning, 5, 233–237. https://doi.org/10.1016/0149-7189(82)90074-x CrossRefGoogle ScholarPubMed
Backhaus, J., Junghanns, K., Broocks, A., Riemann, D., & Hohagen, F. (2002). Test–retest reliability and validity of the Pittsburgh Sleep Quality Index in primary insomnia. Journal of Psychosomatic Research, 53, 737–740. https://doi.org/10.1016/s0022-3999(02)00330-6 CrossRefGoogle ScholarPubMed
Beck, A. T., Epstein, N., Brown, G., & Steer, R. A. (1988). An inventory for measuring clinical anxiety: psychometric properties. Journal of Consulting and Clinical Psychology, 56, 893–897. https://doi.org/10.1037//0022-006x.56.6.893 CrossRefGoogle ScholarPubMed
Beck, A. T., & Steer, R. A. (1991). Relationship between the Beck Anxiety Inventory and the Hamilton Anxiety Rating Scale with anxious outpatients. Journal of Anxiety Disorders, 5, 213–223. https://doi.org/10.1016/0887-6185(91)90002-B CrossRefGoogle Scholar
Beck, A. T., Steer, R. A., & Brown, G. (1996). Beck Depression Inventory Manual (2nd edn). San Antonio, TX, USA: Psychological Corporation.Google Scholar
Behenck, A. D. S., Wesner, A. C., Guimaraes, L. S. P., Manfro, G. G., Dreher, C. B., & Heldt, E. (2021). Anxiety sensitivity and panic disorder: evaluation of the impact of cognitive-behavioral group therapy. Issues in Mental Health Nursing, 42, 112–118. https://doi.org/10.1080/01612840.2020.1780527 CrossRefGoogle ScholarPubMed
Bieling, P. J., McCabe, R. E., & Antony, M. M. (2006). Cognitive-Behavioral Therapy in Groups. New York, USA: Guilford Press.Google Scholar
Buysse, D. J., Reynolds, C. F., Monk, T. H., Berman, S. R., & Kupfer, D. J. (1989). The Pittsburgh Sleep Quality Index: a new instrument for psychiatric practice and research. Psychiatry Research, 28, 193–213. https://doi.org/10.1016/0165-1781(89)90047-4 CrossRefGoogle ScholarPubMed
Chen, H. Y., Cheng, I. C., Pan, Y. J., Chiu, Y. L., Hsu, S. P., Pai, M. F., … & Wu, K. D. (2011). Cognitive-behavioral therapy for sleep disturbance decreases inflammatory cytokines and oxidative stress in hemodialysis patients. Kidney International, 80, 415–422. https://doi.org/10.1038/ki.2011.151 CrossRefGoogle ScholarPubMed
Carney, C. E., Edinger, J. D., Kuchibhatla, M., Lachowski, A. M., Bogouslavsky, O., Krystal, A. D., & Shapiro, C. M. (2017). Cognitive behavioral insomnia therapy for those with insomnia and depression: a randomized controlled clinical trial. Sleep, 40, zsx019. https://doi: 10.1093/sleep/zsx019CrossRefGoogle ScholarPubMed
Cunningham, J., & Shapiro, C. M. (2018). Cognitive behavioural therapy for insomnia (CBT-I) to treat depression: a systematic review. Journal of Psychosomatic Research, 106, 1–12. https://doi.org/10.1016/j.jpsychores.2017.12.012 CrossRefGoogle ScholarPubMed
Diefenbach, G. J., Tolin, D. F., Hannan, S., Maltby, N., & Crocetto, J. (2006). Group treatment for trichotillomania: behavior therapy versus supportive therapy. Behavior Therapy, 37, 353–363. https://doi.org/10.1016/j.beth.2006.01.006 CrossRefGoogle ScholarPubMed
Duarte, P. S., Miyazaki, M. C., Blay, S. L., & Sesso, R. (2009). Cognitive-behavioral group therapy is an effective treatment for major depression in hemodialysis patients. Kidney International, 76, 414–421. https://doi.org/10.1038/ki.2009.156 CrossRefGoogle ScholarPubMed
Espie, C. A., Emsley, R., Kyle, S. D., Gordon, C., Drake, C. L., Siriwardena, A. N., Cape, J., Ong, J. C., Sheaves, B., Foster, R., Freeman, D., Costa-Font, J., Marsden, A., & Luik, A. I. (2019). Effect of digital cognitive behavioral therapy for insomnia on health, psychological well-being, and sleep-related quality of life: a randomized clinical trial. JAMA Psychiatry, 76, 21–30. https://doi.org/10.1001/jamapsychiatry.2018.2745 CrossRefGoogle ScholarPubMed
Geoffroy, P. A., Hoertel, N., Etain, B., Bellivier, F., Delorme, R., Limosin, F., & Peyre, H. (2018). Insomnia and hypersomnia in major depressive episode: prevalence, sociodemographic characteristics and psychiatric comorbidity in a population-based study. Journal of Affective Disorders, 226, 132–141. https://doi.org/10.1016/j.jad.2017.09.032 CrossRefGoogle ScholarPubMed
Gerogianni, G., Babatsikou, F., Polikandrioti, M., & Grapsa, E. (2019). Management of anxiety and depression in haemodialysis patients: the role of non-pharmacological methods. International Urology and Nephrology, 51, 113–118. https://doi.org/10.1007/s11255-018-2022-7 CrossRefGoogle ScholarPubMed
Gohari, N., Sajadi, E., Azvantash, Z., & Khavarghazalani, B. (2020). A comparative study on the general health of the mothers of children with cochlear implant, hearing aid, and normal hearing. Auditory and Vestibular Research, 29, 117–121. https://doi.org/10.18502/avr.v29i2.2793 Google Scholar
Goldberg, D. P., Rickels, K., Downing, R., & Hesbacher, P. (1976). A comparison of two psychiatric screening tests. British Journal of Psychiatry, 129, 61–67. https://doi.org/10.1192/bjp.129.1.61 CrossRefGoogle ScholarPubMed
Cukor, D., Ver Halen, N., & Fruchter, Y. (2013). Anxiety and quality of life in ESRD. Seminars in Dialysis, 26, 265–268. https://doi.org/10.1111/sdi.12065 CrossRefGoogle ScholarPubMed
Guy, W. (1976). ECDEU Assessment Manual for Psychopharmacology. US Department of Health, Education, and Welfare publication (ADM) 76-338, pp. 218–222. Rockville, MD, USA: National Institute of Mental Health.Google Scholar
Hawamdeh, S., Almari, A. M., Almutairi, A. S., & Dator, W. L. T. (2017). Determinants and prevalence of depression in patients with chronic renal disease, and their caregivers. International Journal of Nephrology and Renovascular Disease, 10, 183–189. https://doi.org/10.2147/ijnrd.S139652 CrossRefGoogle ScholarPubMed
Hedayati, S. S., Bosworth, H. B., Briley, L. P., Sloane, R. J., Pieper, C. F., Kimmel, P. L., & Szczech, L. A. (2008). Death or hospitalization of patients on chronic hemodialysis is associated with a physician-based diagnosis of depression. Kidney International, 74, 930–936. https://doi.org/10.1038/ki.2008.311 CrossRefGoogle ScholarPubMed
Henriksson, S., Anclair, M., & Hiltunen, A. J. (2016). Effectiveness of cognitive behavioral therapy on health-related quality of life: an evaluation of therapies provided by trainee therapists. Scandinavian Journal of Psychology, 57, 215–222. https://doi.org/10.1111/sjop.12291 CrossRefGoogle ScholarPubMed
Hill, N. R., Fatoba, S. T., Oke, J. L., Hirst, J. A., O’Callaghan, C. A., Lasserson, D. S., & Hobbs, F. D. (2016). Global prevalence of chronic kidney disease – a systematic review and meta-analysis. PLOS One, 11, e0158765. https://doi.org/10.1371/journal.pone.0158765 CrossRefGoogle ScholarPubMed
Hou, Y., Hu, P., Liang, Y., & Mo, Z. (2014). Effects of cognitive behavioral therapy on insomnia of maintenance hemodialysis patients. Cell Biochemistry and Biophysics, 69, 531–537. https://doi.org/10.1007/s12013-014-9828-4.CrossRefGoogle ScholarPubMed
Ibrahim, J., Hazzan, A. D., Mathew, A. T., Sakhiya, V., Zhang, M., Halinski, C., & Fishbane, S. (2018). Medication discrepancies in late-stage chronic kidney disease. Clinical Kidney Journal, 11, 507–512. https://doi.org/10.1093/ckj/sfx135 CrossRefGoogle ScholarPubMed
Ignatyev, Y., Assimov, M., Aichberger, M. C., Ivens, S., Mir, J., Dochshanov, D., … & Mundt, A. P. (2012). Psychometric properties of a Russian version of the General Health Questionnaire-28. Psychopathology, 45, 252–258. https://doi.org/10.1159/000334918 CrossRefGoogle ScholarPubMed
Jacobs, G. D., Pace-Schott, E. F., Stickgold, R., & Otto, M. W. (2004). Cognitive behavior therapy and pharmacotherapy for insomnia: a randomized controlled trial and direct comparison. Archives of Internal Medicine, 164, 1888–1896. https://doi.org/10.1001/archinte.164.17.1888 CrossRefGoogle ScholarPubMed
Jansson, M., & Linton, S. J. (2005). Cognitive-behavioral group therapy as an early intervention for insomnia: a randomized controlled trial. Journal of Occupational Rehabilitation, 15, 177–190. https://doi.org/10.1007/s10926-005-1217-9 CrossRefGoogle ScholarPubMed
K/DOQI Workgroup (2005). K/DOQI clinical practice guidelines for cardiovascular disease in dialysis patients. American Journal of Kidney Diseases, 45, S1–S153. PMID: 15806502.Google Scholar
Kelly, P. J., Kyngdon, F., Ingram, I., Deane, F. P., Baker, A. L., & Osborne, B. A. (2018). The Client Satisfaction Questionnaire-8: psychometric properties in a cross-sectional survey of people attending residential substance abuse treatment. Drug and Alcohol Review, 37, 79–86. https://doi.org/10.1111/dar.12522 CrossRefGoogle Scholar
Khaledipaveh, B., Khazaie, H., Salari, N., & Maazinezhad, S. (2018). The effect of transcutaneous electrical acupoint stimulation on sleep quality in chronic insomnia disorder. Scientific Journal of Kurdistan University of Medical Sciences, 5, 83–94. https://sjku.muk.ac.ir/article-1-4795-fa.pdf Google Scholar
Kiani, B., Bagheri, N., Tara, A., Hoseini, B., Hashtarkhani, S., & Tara, M. (2018). Comparing potential spatial access with self-reported travel times and cost analysis to haemodialysis facilities in North-eastern Iran. Geospatial Health, 13. https://doi.org/10.4081/gh.2018.703 CrossRefGoogle Scholar
Larsen, D. L., Attkisson, C. C., Hargreaves, W. A., & Nguyen, T. D. (1979). Assessment of client/patient satisfaction: development of a general scale. Evaluation and Program Planning, 2, 197–207. https://doi.org/10.1016/0149-7189(79)90094-6 CrossRefGoogle ScholarPubMed
Loosman, W. L., Rottier, M. A., Honig, A., & Siegert, C. E. (2015). Association of depressive and anxiety symptoms with adverse events in Dutch chronic kidney disease patients: a prospective cohort study. BMC Nephrology, 16, 155. https://doi.org/10.1186/s12882-015-0149-7 CrossRefGoogle ScholarPubMed
Martin, D. J., Garske, J. P., & Davis, M. K. (2000). Relation of the therapeutic alliance with outcome and other variables: a meta-analytic review. Journal of Consulting and Clinical Psychology, 68, 438–450. https://psycnet.apa.org/buy/2000-15699-009 CrossRefGoogle ScholarPubMed
McDade-Montez, E. A., Christensen, A. J., Cvengros, J. A., & Lawton, W. J. (2006). The role of depression symptoms in dialysis withdrawal. Health Psychology, 25, 198–204. https://doi.org/10.1037/0278-6133.25.2.198 CrossRefGoogle ScholarPubMed
Mirghaed, M. T., Sepehrian, R., Rakhshan, A., & Gorji, H. (2019). Sleep quality in Iranian hemodialysis patients: a systematic review and meta-analysis. Iranian Journal of Nursing and Midwifery Research, 24, 403–409. https://doi.org/10.4103/ijnmr.IJNMR_184_18 Google ScholarPubMed
Mitchell, M. D., Gehrman, P., Perlis, M., & Umscheid, C. A. (2012). Comparative effectiveness of cognitive behavioral therapy for insomnia: a systematic review. BMC Family Practice, 13, 40. https://doi.org/10.1186/1471-2296-13-40 CrossRefGoogle ScholarPubMed
Mogharab, M., Nateghi, K., Shamaie-Zavareh, A., & Sharifzadeh, G. (2016). The correlation of religious orientation with depression among critical care and emergency room nurses. Modern Care Journal, 13, 1–6. https://doi: 10.5812/modernc.12470 CrossRefGoogle Scholar
Morin, C. M., Blais, F., & Savard, J. (2002). Are changes in beliefs and attitudes about sleep related to sleep improvements in the treatment of insomnia? Behaviour Research and Therapy, 40, 741–752. https://doi.org/10.1016/s0005-7967(01)00055-9 CrossRefGoogle ScholarPubMed
Ng, C. Z., Tang, S. C., Chan, M., Tran, B. X., Ho, C. S., Tam, W. W., … & Ho, R. C. (2019). A systematic review and meta-analysis of randomized controlled trials of cognitive behavioral therapy for hemodialysis patients with depression. Journal of Psychosomatic Research, 126, 109834. https://doi.org/10.1016/j.jpsychores.2019.109834 CrossRefGoogle ScholarPubMed
Paardekooper, D., Thayer, Z., Miller, L., Nikpour, A., & Gascoigne, M. B. (2020). Group-based cognitive behavioral therapy program for improving poor sleep quality and quality of life in people with epilepsy: a pilot study. Epilepsy & Behavior, 104, 106884. https://doi.org/10.1016/j.yebeh.2019.106884 CrossRefGoogle ScholarPubMed
Pagel, J. F., & Parnes, B. L. (2001). Medications for the treatment of sleep disorders: an overview. Primary Care Companion to the Journal of Clinical Psychiatry, 3, 118–125. https://doi.org/10.4088/pcc.v03n0303 CrossRefGoogle ScholarPubMed
Palmer, S. C., Natale, P., Ruospo, M., Saglimbene, V. M., Rabindranath, K. S., Craig, J. C., & Strippoli, G. F. (2016). Antidepressants for treating depression in adults with end-stage kidney disease treated with dialysis. Cochrane Database of Systematic Reviews, 5, CD004541. https://doi.org/10.1002/14651858.CD004541.pub3 Google Scholar
Picariello, F., Moss-Morris, R., Macdougall, I. C., Norton, S., Da Silva-Gane, M., Farrington, K., … & Chilcot, J. (2018). Cognitive-behavioural therapy (CBT) for renal fatigue (BReF): a feasibility randomised-controlled trial of CBT for the management of fatigue in haemodialysis (HD) patients. BMJ Open, 8, e020842. https://doi.org/10.1136/bmjopen-2017-020842 CrossRefGoogle ScholarPubMed
Pigeon, W. R. (2010). Treatment of adult insomnia with cognitive-behavioral therapy. Journal of Clinical Psychology, 66, 1148–1160. https://doi.org/10.1002/jclp.20737 CrossRefGoogle ScholarPubMed
Qaseem, A., Kansagara, D., Forciea, M. A., Cooke, M., Denberg, T. D., & Clinical Guidelines Committee of the American College of Physicians (2016). Management of chronic insomnia disorder in adults: a clinical practice guideline from the American College of Physicians. Annals of Internal Medicine, 165, 125–133. https://doi.org/10.7326/M15-2175 CrossRefGoogle ScholarPubMed
Quek, K. F., Low, W. Y., Razack, A. H., & Loh, C. S. (2001). Reliability and validity of the General Health Questionnaire (GHQ-12) among urological patients: a Malaysian study. Psychiatry and Clinical Neurosciences, 55, 509–513. https://doi.org/10.1046/j.1440-1819.2001.00897.x CrossRefGoogle ScholarPubMed
Ramsawh, H. J., Stein, M. B., Belik, S. L., Jacobi, F., & Sareen, J. (2009). Relationship of anxiety disorders, sleep quality, and functional impairment in a community sample. Journal of Psychiatric Research, 43, 926–933. https://doi.org/10.1016/j.jpsychires.2009.01.009 CrossRefGoogle Scholar
Shareh, H. (2014). Validation and investigating the psychometric properties of the client satisfaction questionnaire and client clinical global index in a sample of patients with obsessive-compulsive disorder. Unpublished manuscript.Google Scholar
Shareh, H., Ghodsi, M., & Keramati, S. (2022). Emotion-focused group therapy among women with premenstrual dysphoric disorder: a randomized clinical trial. Psychotherapy Research: Journal of the Society for Psychotherapy Research, 32, 440–455. https://doi.org/10.1080/10503307.2021.1980239 CrossRefGoogle ScholarPubMed
Shochat, T., Tzischinsky, O., Oksenberg, A., & Peled, R. (2007). Validation of the Pittsburgh Sleep Quality Index Hebrew translation (PSQI-H) in a sleep clinic sample. Israel Medical Association Journal, 9, 853–856. https://pubmed.ncbi.nlm.nih.gov/18210924/ Google Scholar
Smits, D., Luyckx, K., Smits, D., Stinckens, N., & Claes, L. (2015). Structural characteristics and external correlates of the Working Alliance Inventory-Short Form. Psychological Assessment, 27, 545–551. https://doi.org/10.1037/pas0000066 CrossRefGoogle ScholarPubMed
Sohn, B. K., Oh, Y. K., Choi, J. S., Song, J., Lim, A., Lee, J. P., … & Lim, C. S. (2018). Effectiveness of group cognitive behavioral therapy with mindfulness in end-stage renal disease hemodialysis patients. Kidney Research and Clinical Practice, 37, 77–84. https://doi.org/10.23876/j.krcp.2018.37.1.77 CrossRefGoogle ScholarPubMed
Stevens, J. P. (2002). Applied Multivariate Statistics for the Social Sciences. Mahwah, NJ, USA: Lawrence Erlbaum Associates.Google Scholar
Targum, S. D., Hassman, H., Pinho, M., & Fava, M. (2012). Development of a clinical global impression scale for fatigue. Journal of Psychiatric Research, 46, 370–374. https://doi.org/10.1016/j.jpsychires.2011.12.001 CrossRefGoogle ScholarPubMed
Taylor, R. R. (2009). Cognitive Behavioral Therapy for Chronic Illness and Disability. USA: Springer.Google Scholar
Tracey, T. J., & Kokotovic, A. M. (1989). Factor structure of the Working Alliance Inventory. Psychological Assessment, 1, 207–210. https://doi.org/10.1037/1040-3590.1.3.207 CrossRefGoogle Scholar
Trauer, J. M., Qian, M. Y., Doyle, J. S., Rajaratnam, S. M., & Cunnington, D. (2015). Cognitive behavioral therapy for chronic insomnia: a systematic review and meta-analysis. Annals of Internal Medicine, 163, 191–204. https://doi.org/10.7326/M14-2841 CrossRefGoogle ScholarPubMed
Tucker, M., & Oei, T. P. (2007). Is group more cost effective than individual cognitive behavior therapy? The evidence is not solid yet. Behavioral and Cognitive Psychotherapy, 35, 77–91. https://doi.org/10.1017/S1352465806003134 CrossRefGoogle Scholar
Valsaraj, B. P., Bhat, S. M., & Latha, K. S. (2016). Cognitive behaviour therapy for anxiety and depression among people undergoing haemodialysis: a randomized control trial. Journal of Clinical and Diagnostic Rresearch, 10, VC06–VC10. https://doi.org/10.7860/jcdr/2016/18959.8383 Google ScholarPubMed
Wilson, S., Anderson, K., Baldwin, D., Dijk, D.-J., Espie, A., Espie, C., Gringras, P., Krystal, A., Nutt, D., Selsick, H., & Sharpley, A. (2019). British Association for Psychopharmacology consensus statement on evidence-based treatment of insomnia, parasomnias and circadian rhythm disorders: an update. Journal of Psychopharmacology, 33, 923–947. https://doi.org/10.1177/0269881119855343 CrossRefGoogle ScholarPubMed
Yalom, I. D., & Leszcz, M. (collaborator) (2005). The Theory and Practice of Group Psychotherapy (5th edn). Basic Books/Hachette Book Group.Google Scholar
Submit a response

Comments

No Comments have been published for this article.