Effect of a Nurse-Led Psychoeducational Support Program on Caregiver Burden and Anxiety in Chronic Hemodialysis

Abstract

Background:
Informal caregiving for patients with end-stage renal disease undergoing maintenance hemodialysis is associated with substantial caregiver burden, psychological distress, and reduced quality of life.
Objectives: To evaluate the efficacy of a nurse-led psychoeducational and support program in reducing caregiver burden and anxiety among family caregivers of hemodialysis patients.
Materials and methods: This study enrolled 90 family caregivers. The intervention group (n = 45) completed an 8-week nurse-led program encompassing counseling, skills training, and stress management, whereas the control group (n = 45) received standard informational materials. Outcomes were assessed using the Zarit Burden Interview (ZBI) and the Hospital Anxiety and Depression Scale (HADS) at baseline and post-intervention.
Results: Severe caregiver burden and anxiety (ZBI > 48) were present in 68.9% of caregivers at baseline. Following the 8-week intervention, mean ZBI scores in the intervention group decreased significantly from 51.4 ± 7.2 to 34.2 ± 5.8 (p < 0.001), and HADS anxiety subscale (HADS-A) scores decreased from 11.8 ± 2.1 to 6.4 ± 1.5 (p < 0.001). Scores in the control group showed no significant change. Patients whose caregivers completed the program exhibited improved dietary and phosphate binder adherence.
Conclusions: A structured nurse-led support program significantly mitigates subjective caregiving burden and anxiety among relatives of hemodialysis patients.

Keywords:
Hemodialysis; family caregivers; caregiver burden; nursing interventions; Zarit Burden Interview; anxiety.