تأثیر آموزش مراقبت از خود بر میزان افسردگی بیماران تحت درمان با همودیالیز

  Background and Aim: Depression is the most common and important psychological disorder among End-Stage Renal Failure cases especially those undergoing hemodialysis so that, it can have negative effects on the quality of life, treatment acceptance and process of illness. Regarding that patients’ participation in self-care activities can help them in their independence and compatibility with their illness and improving of their quality of life (QOL) in all aspects., Therefore, this study was done aiming at determining the effect of self-care education on depression in patients undergoing hemodialysis”.   Materials and Methods: This study was a randomized controlled trial, which was accomplished in the hemodialysis ward of Imam Reza and Hefdeh-e- shahrivar hospitals in Mashhad in 2006. Sixty samples were selected from patients undergoing hemodialysis through convenience and purposeful method and then divided into two (case and control) groups randomly. After need assessment of the patients about self-care, case group education was accomplished by utilizing an educational booklet and holding two sessions (average length of each 45 minutes) with a lapse of one week between them. Depression in both groups before and one month after intervention was measured by CES-D questionnaire. The obtained data was analyzed by statistical tests, paired-T, independent T, x2, Fisher, Mann-Whitney, and general linear model using SPSS software (11.5) and P £ 0.05 was taken as the significant level.   Results: Mean age of the patients was 42.3±12.1 years. 62.5% were males, 78.6% were unemployed, 76.8% married, 42.9% were underpaid, and 33.9% had elementary education. There was not a significant difference between the two groups in these variables. Mean depression score before education (23.7±7.1) and after education (17.2±6.7) showed a significant decrease in the case group (P<0.001). Comparison of mean depression between the case (17.2±6.7) and control group (21.8±6) after the study revealed a significant difference, (P=0.01) while there was no significant difference between them before the research (P=0.40). Mean depression rate in the control group before the study (22.2±5.4) and after the study (21.8±6/0) did not show a significant difference (P=0.51).   Conclusion : In order to have constant and efficient participation in self-care activities of, patients undergoing hemolysis, they need to receive continuous education regarding self-care and adaptation to disease, so that various physical and mental problems they are facing would be decreased.