Strengthening Renal Psychology in Portuguese Dialysis Centres: The Implementation of Evidence‑Informed Psychological Practices

Autores

DOI:

https://doi.org/10.71749/pkj.83

Palavras-chave:

Kidney Failure, Chronic/psychology, Psychological Intervention, Psychometrics, Renal Dialysis/psychology

Resumo

Hemodialysis imposes a significant psychological burden on people receiving this kidney therapy and their families. However, the role of Renal Psychologists remains underrecognized in the majority of nephrology centres worldwide, including in Portugal. This review article presents the rationale, development, and implementation of evidence‑informed psychological assessments and interventions organised in Portuguese dialysis centres. Overall, three resources – two patient‑reported outcome measures that aim to facilitate the triage of psychological distress and its sources in people on hemodialysis (Hemodialysis Distress Thermometer for Patients [HD-DT]) and informal/family caregivers (Hemodialysis Distress Thermometer for Caregivers [HD-DT-C]), and an Internet‑mediated psychoeducational intervention (the Connected We St@nd programme) ‑ are presented and discussed as a means to optimise interdisciplinary collaborations and the expansion of professional psychological support services in (national and international) nephrology care settings.

Downloads

Os dados de download ainda não estão disponíveis.

Referências

United States Renal Data System (USRDS). 2023 Annual Data Report. National Institute of Diabetes and Digestive and Kidney Diseases ‑ United States Renal Data System. [accessed Nov 2024] Available at: https://usrds-adr.niddk.nih.gov/2023/end-stage-renal-disease/11-international-comparisons

Francis A, Harhay MN, Ong ACM, Tummalapalli SL, Ortiz A, Fogo AB, et al. Chronic kidney disease and the global public health agenda: An international consensus. Nat Rev Nephrol. 2024;20:473‑85. doi:10.1038/s41581‑024‑00820‑6

Kidney Care UK and National Psychosocial Working Group. Psychosocial health – A manifesto for action and a campaign for change. Kidney Care UK. [accessed Nov 2024] Available at: https://kcuk.cdn.ngo/media/documents/Kidney_Care_UK_Psychosocial_Manifesto_2022.pdf

Himmelfarb J, Vanholder R, Mehrotra R, Tonelli M. The current and future landscape of dialysis. Nat Rev Nephrol. 2020;16:573‑85. doi:10.1038/s41581‑020‑0315‑4

Cukor D, Donahue S, Tummalapalli SL, Bohmart A, Silberzweig J. Anxiety, comorbid depression, and dialysis symptom burden. Clin J Am Soc Nephrol. 2022;17:1216‑7. doi:10.2215/CJN.01210122

Gebrie MH, Ford J. Depressive symptoms and dietary non‑adherence among end stage renal disease patients undergoing hemodialysis therapy: Systematic review. BMC Nephrol. 2019;20:429. doi:10.1186/s12882‑019‑1622‑5

Bağriaçik E, Dikmen BT. Self‑management training in patients with chronic kidney disease undergoing hemodialysis: A systematic review. Semin Dial. 2024;37:91‑100. doi:10.1111/sdi.13164

Yangöz ŞT, Özer Z, Boz İ. Comparison of the effect of educational and self‑management interventions on adherence to treatment in hemodialysis patients: A systematic review and meta‑analysis of randomized controlled trials. Int J Clin Pract. 2021;75:e13842. doi:10.1111/ijcp.13842

Bernier‑Jean A, Wong G, Saglimbene V, Ruospo M, Palmer SC, Natale P, et al. Dietary potassium intake and all‑cause mortality in adults treated with hemodialysis. Clin J Am Soc Nephrol. 2021;16:1851‑61. doi:10.2215/CJN.08360621

Griva K, Nandakumar M, Ng JH, Lam KF, McBain H, Newman SP. Hemodialysis Self‑management Intervention Randomized Trial (HED‑SMART): A practical low‑intensity intervention to improve adherence and clinical markers in patients receiving hemodialysis. Am J Kidney Dis. 2018;71:371‑81. doi:10.1053/j.ajkd.2017.09.014

Lin CC, Hwang SJ. Patient‑centered self‑management in patients with chronic kidney disease: Challenges and implications. Int J Environ Res Public Health. 2020;17:9443. doi:10.3390/ijerph17249443

Bártolo A, Sousa H, Ribeiro O, Figueiredo D. Effectiveness of psychosocial interventions on the burden and quality of life of informal caregivers of hemodialysis patients: a systematic review. Disabil Rehabil. 2022;44:8176‑87. doi:10.1080/09638288.2021.2013961

McGuigan K, Laurente G, Christie A, Carswell C, Moran C, Yaqoob MM, et al. Effectiveness of interventions for informal caregivers of people with end‑stage chronic illness: A systematic review. Syst Rev. 2024;13:245. doi:10.1186/s13643‑024‑02641‑x

Chilcot J, Pearce CJ, Hall N, Busby AD, Hawkins J, Vraitch B, et al. The identification and management of depression in UK Kidney Care: Results from the Mood Maps Study. J Ren Care. 2024;50:297‑306. doi:10.1111/jorc.12489

Sousa H, Ribeiro O, Figueiredo D. Development process, clinical utility, and preliminary psychometric evidence of a new tool for screening psychological distress in renal care settings: The Hemodialysis Distress Thermometer (HD‑DT). Psychol Health. 2024:1‑27. doi:10.1080/08870446.2024.2347662

Sousa H, Ribeiro O, Figueiredo D. The Hemodialysis Distress Thermometer for Caregivers (HD‑DT‑C): Development and testing of the psychometric properties of a new tool for screening psychological distress among family caregivers of adults on hemodialysis. Qual Life Res. 2024;33:1513‑26. doi:10.1007/s11136‑024‑03627‑x

Sousa H, Ribeiro O, Christensen AJ, Figueiredo D. Designing family‑based interventions in kidney failure: The perspectives of the triad ‘patients on haemodialysis/family caregivers/healthcare professionals. Br J Health Psychol. 2023;28:672‑89. doi:10.1111/bjhp.12647

Sousa H, Ribeiro O, Figueiredo D. End‑stage renal disease is not yours, is not mine, is OURS: Exploring couples lived experiences through dyadic interviews. Hemodial Int. 2021 (in press). doi:10.1111/hdi.12929

Sousa H, Bártolo A, Ribeiro O, Figueiredo D. A family‑centred perspective on the arteriovenous fistula in end‑stage renal disease: Findings from dyadic interviews. Scand J Caring Sci. 2022;36:426‑38. doi:10.1111/scs.13055

Sousa H, Ribeiro O, Christensen AJ, Figueiredo D. Mapping Patients’ Perceived Facilitators and Barriers to In‑Centre Hemodialysis Attendance to the Health Belief Model: Insights from a Qualitative Study. Int J Behav Med. 2023;30:97‑107. doi:10.1007/s12529‑022‑10075‑9

Sousa H, Ribeiro O, Christensen AJ, Figueiredo D. Caring for parents with end‑stage renal disease: What do adult children face and how do they cope?. J Clin Nurs. 2022;31:3454‑63. doi:10.1111/jocn.16172

Sousa H, Ribeiro O, Figueiredo D. Purpose in life among haemodialysis caregivers: Links with adaptive coping, caregiver burden, and psychological distress. Stress Health. 2024;40:e3460. doi:10.1002/smi.3460

Sousa H, Ribeiro O, Paúl C, Costa E, Frontini R, Miranda V, et al. “Together We Stand”: A pilot study exploring the feasibility, acceptability, and preliminary effects of a family‑based psychoeducational intervention for patients on hemodialysis and their family caregivers. Healthcare. 2021;9:1585. doi:10.3390/healthcare9111585

Sousa H, Ribeiro O, Bártolo A, Costa E, Ribeiro F, Rodrigues M, et al. The Connected We St@nd programme: A feasibility pilot study of an online self‑management intervention for adults on in‑centre haemodialysis and family caregivers. Br J Health Psychol. 2024;29:589‑608. doi:10.1111/bjhp.12715

Sousa H, Ribeiro O, Bártolo A, Rodrigues M, Costa E, Quental J, et al. Clinical Relevance of an online self‑management intervention in haemodialysis: A secondary data analysis of the ‘Connected We St@nd’ Programme. J Ren Care. 2025;51:e70012. doi:10.1111/jorc.70012

Budak S. Haemodialysis distress thermometer scale: Turkish validity and reliability study. Int Urol Nephrol. 2025 (in press). doi:10.1007/s11255‑025‑04574‑3

Elhenawy YI, Eltonbary KY. Glycemic control among children and adolescents with type 1 diabetes during COVID‑19 pandemic in Egypt: A pilot study. Int J Diabetes Dev Ctries. 2021;41:389‑95. doi:10.1007/s13410‑021‑00968‑y

Trevino KM, Raghunathan N, Latte‑Naor S, Polubriaginof FG, Jensen C, Atkinson TM, et al. Rapid deployment of virtual mind‑body interventions during the COVID‑19 outbreak: Feasibility, acceptability, and implications for future care. Support Care Cancer. 2021;29:543‑6. doi:10.1007/s00520‑020‑05740‑2

Sousa H. We‑Disease: Promoting psychosocial adjustment and adherence in end‑stage renal disease through a family‑based intervention [Doctoral Thesis]. Aveiro: University of Aveiro; 2025

GBD Chronic Kidney Disease Collaboration. Global, regional, and national burden of chronic kidney disease, 1990‑2017: A systematic analysis for the Global Burden of Disease Study 2017. Lancet. 2020;395:709‑33. doi:10.1016/S0140‑6736(20)30045‑3

Farinha A, Coelho P, Rodrigues A. Conservative care management in chronic kidney disease: a value for the money? Port Kidney J. 2024;38:35‑42.

Sociedade Portuguesa de Nefrologia (SPN). Registo Nacional da Doença Renal Crónica da Sociedade Portuguesa de Nefrologia. Published 2023. [accessed May 2024] Available at: https://www.spnefro.pt/assets/relatorios/tratamento_doenca_terminal/registo-nacional-de-doenca-renal-cronicav4-apresentacao-dmr.pdf

Gonzalez JS, McCarl LA, Wexler D, Cagliero E, Delahanty L, Soper TD, et al. Cognitive Behavioral Therapy for Adherence and Depression (CBT‑AD) in Type 2 Diabetes. J Cogn Psychother. 2010;24:329‑43. doi:10.1891/0889‑8391.24.4.329

Zu W, Zhang S, Du L, Huang X, Nie W, Wang L. The effectiveness of psychological interventions on diabetes distress and glycemic level in adults with type 2 diabetes: a systematic review and meta‑analysis. BMC Psychiatry. 2024;24:660. doi:10.1186/s12888‑024‑06125‑z

Downloads

Publicado

2025-06-18

Declaração de Disponibilidade de Dados Científicos

No data were produced for this paper.

Edição

Secção

Review Article

Como Citar

Strengthening Renal Psychology in Portuguese Dialysis Centres: The Implementation of Evidence‑Informed Psychological Practices. (2025). Revista Portuguesa De Nefrologia. https://doi.org/10.71749/pkj.83

Artigos mais lidos do(s) mesmo(s) autor(es)

Artigos Similares

1-10 de 48

Também poderá iniciar uma pesquisa avançada de similaridade para este artigo.