The Application Of Rational-emotive Therapy (RET) In Maintenance Hemodialysis

ObjectiveTo determine the effect of Rational-emotive therapy (RET) in improving emotion, automatic thought, self acceptance, and sleep quality of maintenance hemodialysis (MHD) patients.Subject and MethodsSubjects fulfilled the following conditions: age≥ 18 years, duration of MHD (twice a week) ≥3 months, condition was under control;no malignancy, severe disability, and no major surgical operation in 3 months prior;no history of severe mental illness, psychiatric disorder, or severe impairment of vision and hearing. 80 subjects were recruited for the interview and administered with Self-Rating Depression Scale (SDS), Automatic Thought Questionnaire (ATQ), Self Acceptance Questionnaire (SAQ), and Pittsburgh Sleep Quality Index (PSQI). From the pool, 41 patients whose SDS score>40 were elected and divided randomly into two groups for further study. Mental intervention was applied: patients under standard care from treatment group were remediedwith rational-emotive therapy twice a week, 30 minutes each time, for a duration of 6 weeks;while the controls were just given standard care. All patients were assessed with scales mentioned above before and after the intervention at the same period of time. Statistical significance was assessed using the SPSS 11.0 for Windows. Results were expressed in x±s. Differences between groups were tested using T tests and Pearson tests.Results1. Of the total, 50.25% MHD patients had depressive disorders (SDS score>40), and 70.00% showed different degree of sleep problems (PSQI score>7).2. Patients' depressive emotion was directly related to negative automatic thought (P<0.0\) and sleep problems (P<0.05), but inversely related to self acceptance (P<0.01). Patients manifested depressive symptoms showed high level of automatic thought and low level of self acceptance.3. After intervention, SDS scores of the patients from treatment group were decreased (before 58.24±5.70, after 45.10±6.33) significantly (.P<0.01). Simultaneously, the level of self acceptance (before 37.52±5.30, after 41.57±4.85) and the self acceptance factor score (before 18.81±3.63, after 21.24±2.74) were both increased significantly (P<0.05). Besides, sleep quality of the treatment group was also improved (before 14.05±9.97, after 7.48±4.40) significantly. On the other hand, no score difference was observed in the control after 6 weeks of time.Conclusions1. The rate of depressive disorders among MHD patients was high;most of the patients showed high degree of automatic thought and low degree of self acceptance, and many patients were suffering a certain degree of sleeping problems. There was a relation between depressive emotion and automatic thought, self acceptance, and sleep quality.2. RET could improved the emotion of MHD patients, enhance self acceptance, reduce automatic thought, and reform sleeping quality. Clinical routine of mental intervention need to be established among MHD patients.