Using Problem-solving Therapy to Improve Problem-solving Orientation, Problem-solving Skills and Quality of Life in Older Hemodialysis Patients

Clin Gerontol. 2018 Oct-Dec;41(5):424-437. doi: 10.1080/07317115.2017.1371819. Epub 2017 Nov 29.

Abstract

Objectives: To determine the effectiveness of Problem-Solving Therapy (PST) in older hemodialysis (HD) patients by assessing changes in health-related quality of life and problem-solving skills.

Methods: 33 HD patients in an outpatient hemodialysis center without active medical and psychiatric illness were enrolled. The intervention group (n = 15) received PST from a licensed social worker for 6 weeks, whereas the control group (n = 18) received usual care treatment.

Results: In comparison to the control group, patients receiving PST intervention reported improved perceptions of mental health, were more likely to view their problems with a positive orientation and were more likely to use functional problem-solving methods. Furthermore, this group was also more likely to view their overall health, activity limits, social activities and ability to accomplish desired tasks with a more positive mindset.

Conclusions: The results demonstrate that PST may positively impact mental health components of quality of life and problem-solving coping among older HD patients.

Clinical implications: PST is an effective, efficient, and easy to implement intervention that can benefit problem-solving abilities and mental health-related quality of life in older HD patients. In turn, this will help patients manage their daily living activities related to their medical condition and reduce daily stressors.

Keywords: Coping; hemodialysis; problem-solving therapy; quality of life.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adaptation, Psychological*
  • Aged
  • Depression / etiology
  • Depression / therapy*
  • Humans
  • Kidney Failure, Chronic / psychology
  • Kidney Failure, Chronic / therapy
  • Pilot Projects
  • Problem Solving*
  • Psychotherapy / methods*
  • Quality of Life*
  • Renal Dialysis / psychology*