CoChat
Sign Up
Cited by 13Nursing care and researchFamily Caregiving in Mental IllnessDialysis and Renal Disease Management

Stress management training program to address caregiver burden and perceived stress among family caregivers of patients undergoing hemodialysis: a randomized controlled trial study

Open access
Khouban-Shargh, Ramisa, Mirhosseini, Seyedmohammad, Ghasempour, Saeed, Basirinezhad, Mohammad Hasan, Abbasi, Ali·2024·BMC Nephrology
DOI 10.1186/s12882-024-03795-5PMC PMC11476389
Open this paper in CoChat — free accountOpen PDF

Abstract

Background: The objective of the current study was to assess the effectiveness of stress management training, grounded in Lazarus and Folkman’s stress management model, on reducing caregiving burden and perceived stress among family caregivers of patients on hemodialysis. Methods: This two-group clinical trial study was conducted in parallel design among 60 family caregivers of patients on hemodialysis in 2023. The participants were divided into two groups of training and control using a random quadruple block allocation method. The intervention took place over two months, in six online group sessions of 35–45 min. Zarit Burden Inventory (ZBI) and Cohen’s Perceived Stress Scale (PSS-14) were used to collect information before and two weeks after the intervention. The study data were analyzed using and analysis of covariance (ANCOVA), pair, and independent t-tests at a significance level of 0.05. Results: At baseline, the two groups exhibited homogeneity in terms of mean scores for caregiving burden (Training group = 50.8 ± 4.9; Control group = 49.1 ± 6.0; P = 0.264) and perceived stress (Training group = 32.8 ± 4.7; Control group = 31.5 ± 2.4; P = 0.192). Nevertheless, following the intervention, there was a significant decrease in caregiving burden (Training group = 45.9 ± 4.1; Control group = 49.0 ± 5.8; P = 0.017) and perceived stress (Training group = 28.0 ± 4.4; Control group = 30.7 ± 3.5; P = 0.01) scores within the training group compared to the control group. Conclusion: Based on the findings of the current study, given that family caregivers of patients on hemodialysis encounter psychological distress and contend with the negative aspects of care, it is advisable to implement psycho-educational interventions, such as stress management training. Incorporating these interventions into the care plan for hemodialysis could help mitigate these adverse consequences and provide valuable support for family caregivers. Trial registration: Iranian Registry of Clinical Trials (IRCT), IRCT20180728040617N6. Registered on 17/04/2023.

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Integrity signals

Registry

Crossref · 10.1186/s12882-024-03795-5

Cites

1 of 1 references verified0 citation errors · 0 not checkable

Statistics

Claims the paper makes

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

  • By engaging in direct communication with fellow caregivers who share similar circumstances, individuals gain a deeper understanding of the emotions, experiences, and challenges associated with caregiving.

    “By engaging in direct communication with fellow caregivers who share similar circumstances, individuals gain a deeper understanding of the emotions, experiences, and challenges associated with caregiving (Bilenchi et al., 2022; Khouban-Shargh et al., 2024).”

    From Support based on psychoeducation intervention to address quality of life and care burden among caregivers of patients with cancer: a randomized controlled trial (2025) · cites this paper as Khouban-Shargh et al., 2024

    The Methods > Intervention section (page unavailable) describes group discussions in which caregivers shared experiences and challenges. The Discussion says this sharing enhanced their ability to care for patients, but does not say that direct communication gave them a deeper understanding of caregiving emotions, experiences, and challenges. (LLM, conf=0.85)

    Experimental — accuracy not yet measured

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

The self-check needs the paper’s full text.

Cites

Flagged first, then by citations

Research works printed but not linked: 47

  1. [1]Janssen IM, Gerhardus A, von Gersdorff GD, Baldamus CA, Schaller M, Barth C, Scheibler F. Preferences of patients undergoing hemodialysis - results from a questionnaire-based study with 4,518 patients. Patient Prefer Adherence. 2015;9:847–55. 26170634 PMC4492657 · DOI
  2. [2]Cantekin I, Kavurmacı M, Tan M. An analysis of caregiver burden of patients with hemodialysis and peritoneal dialysis. Hemodial Int. 2016;20(1):94–7. 26549410 · DOI
  3. [3]Ayoub AM, Hijjazi KH. Quality of life in dialysis patients from the United Arab Emirates. J Fam Commun Med. 2013;20(2):106. PMC3748644 23983562 · DOI
  4. [4]Zahedi S, Darvishpoor Kakhaki A, Hosseini M, Razzaghi Z. The correlation between self-care and health literacy in patients undergoing hemodialysis. Iran J Diabetes Metabolism. 2018;17(4):180–8.
  5. [5]Hejazian SM, Ahmadian E, Zununi Vahed S, Faraji Gogani L, Farnood F. The Association of Sleep Quality and Vitamin D Levels in Hemodialysis Patients. BioMed Research International 2021, 2021:4612091. PMC8481063 34604382
  6. [6]Chhetri SK, Baral R. Caregiver Burden among caregivers of patient undergoing hemodialysis in Tertiary Care Center: a descriptive cross-sectional study. J Nepal Med Association. 2020;58(223):148–52. PMC7580316 32347819 · DOI
  7. [7]Bağ E, Mollaoğlu M. The evaluation of self-care and self‐efficacy in patients undergoing hemodialysis. J Eval Clin Pract. 2010;16(3):605–10. 19874435 · DOI
  8. [8]Ghane G, Farahani MA, Seyedfatemi N, Haghani H. The effect of supportive educative program on the quality of life in family caregivers of hemodialysis patients. J Educ Health Promotion 2017, 6. PMC5651656 29114548
  9. [9]Haresabadi M, Bibak B, Bayati M, Arki M, Akbari H. Assessing burden of family caregivers of patients with schizophrenia admitted in Imam Reza Hospital-Bojnurd 2010. J North Khorasan Univ Med Sci. 2012;4(2):165–71.
  10. [10]Gayomali C, Sutherland S, Finkelstein FO. The challenge for the caregiver of the patient with chronic kidney disease. In., vol. 23: Oxford University Press; 2008: 3749–3751. 19028759
  11. [12]Jafari H, Ebrahimi A, Aghaei A, Khatony A. The relationship between care burden and quality of life in caregivers of hemodialysis patients. BMC Nephrol. 2018;19(1):321. 30419837 PMC6233261 · DOI
  12. [13]Menati L, Torabi Y, Andayeshgar B, Khatony A. The relationship between Care Burden and coping strategies in caregivers of Hemodialysis patients in Kermanshah, Iran. Psychol Res Behav Manage. 2020;13:133–40. PMC7008190 32104113 · DOI
  13. [14]Rha SY, Park Y, Song SK, Lee CE, Lee J. Caregiving burden and the quality of life of family caregivers of cancer patients: the relationship and correlates. Eur J Oncol Nurs. 2015;19(4):376–82. 25795160 · DOI
  14. [15]Dehghani Y, Omranifard V, Babamiri M. The Effectiveness of Communication Skills Training on Caregiving Burden and Quality of Life among Family caregivers of Elderly with Dementia. J Res Behav Sci. 2016;14(2):161–7.
  15. [16]Gerogianni G, Polikandrioti M, Babatsikou F, Zyga S, Alikari V, Vasilopoulos G, Gerogianni S, Grapsa E. Anxiety-depression of Dialysis patients and their caregivers. Med (Kaunas) 2019, 55(5). PMC6572629 31137563
  16. [17]Gerogianni G, Polikandrioti M, Alikari V, Vasilopoulos G, Zartaloudi A, Koutelekos I, Kalafatakis F, Babatsikou F. Factors affecting anxiety and depression in caregivers of Hemodialysis patients. Adv Exp Med Biol. 2021;1337:47–58. 34972890 · DOI
  17. [18]Tao Y, Liu T, Zhuang K, Fan L, Hua Y, Ni C. Perceived stress, social support, and insomnia in hemodialysis patients and their family caregivers: an actor-partner interdependence mediation model analysis. Front Psychol 2023, 14. PMC10342196 37457101
  18. [19]Cohen S, Kamarck T, Mermelstein R. A global measure of perceived stress. J Health Soc Behav 1983:385–96. 6668417
  19. [20]Campbell AR. Family caregivers: caring for aging end-stage renal disease partners. Adv Renal Replace Ther. 1998;5(2):98–108. 9554543 · DOI
  20. [21]Sarwar A, Abdullah MI, Sarfraz M, Imran MK. Collaborative effect of workplace ostracism and self-efficacy versus job stress. J Entrepreneurship Manage Innov. 2019;15(4):107–38. · DOI
  21. [23]Barkhordari-Sharifabad M, Mousavi N-S. The effect of spiritual skills training on the Quality of Life of Family Caregivers of Hemodialysis patients. Avicenna J Nurs Midwifery Care. 2022;30(4):280–7.
  22. [24]Mousaei FM, Mirhosseini S, Mafi MH, Günaydın N, Zendehtalab HR. Effect of support based on family centered empowerment model on care burden in family caregivers of patients with multiple sclerosis. Front Public Health. 2023;11:1115311. 37521993 PMC10372413 · DOI
  23. [25]Mirhosseini S, Hosseini Nezhad FS, Haji Mohammad Rahim A, Basirinezhad MH, Bakhshiarab A, Saeedi M, Ebrahimi H. Care burden and the predictive role of spiritual well-being and religious coping: a cross sectional study among Iranian family caregivers of patients with stroke. Health Sci Rep. 2024;7(6):e2155. 38841117 PMC11150275 · DOI
  24. [26]Mirhosseini S, Heshmati Nabavi F, Behnam Vashani H, Vaghee S. Evaluating the effect of online psychoeducational support group on perceived stress in family caregivers of COVID-19 survivors. OMEGA-Journal Death Dying 2022:00302228221126219. 36069743
  25. [27]Lazarus RS, Folkman S. Stress, appraisal, and coping. Springer publishing company; 1984.
  26. [29]Zarit SH, Reever KE, Bach-Peterson J. Relatives of the impaired elderly: correlates of feelings of burden. Gerontologist. 1980;20(6):649–55. 7203086 · DOI · Paper page
  27. [30]Ata EE, Doğan S. The effect of a brief cognitive behavioural stress management programme on mental status, coping with stress attitude and caregiver burden while caring for schizophrenic patients. Arch Psychiatr Nurs. 2018;32(1):112–9. 29413060 · DOI
  28. [31]Hemmati Maslakpak M, Torabi M, Radfar M, Alinejad V. The effect of psycho-educational intervention on the caregiver burden among caregivers of hemodialysis patients. J Res Dev Nurs Midwifery. 2019;16(1):13–24.
  29. [32]Rabiei L, Eslami AA, Abbasi M, Afzali SM, Hosseini SM, Masoudi R. Evaluating the effect of family-centered intervention program on care burden and self-efficacy of hemodialysis patient caregivers based on social cognitive theory: a randomized clinical trial study. Korean J Family Med. 2020;41(2):84. PMC7093670 31958941 · DOI
  30. [33]Bahrami N, Pahlavanzadeh S, Marofi M. Effect of a supportive training program on anxiety in children with chronic kidney problems and their mothers’ caregiver Burden. Iran J Nurs Midwifery Res. 2019;24(3):193. 31057635 PMC6485030 · DOI
  31. [34]Chu SY, Ibrahim N, Amit N, Gafor AHA, Ismail R, Lee KW, Siau CS. Interventions to reduce Caregiver Burden among caregivers of chronic kidney disease (CKD) patients: a scoping review. SAGE Open. 2023;13(2):21582440231178703. · DOI
  32. [35]Taheri S, Mafi M, Mafi MH, Kasirlou L. The effect of group logo therapy on the burden of hemodialysis patients’ caregivers. J Ren Injury Prev. 2020;9(4):e33–33. · DOI
  33. [36]Van Den Heuvel ET, De Witte LP, Stewart RE, Schure LM, Sanderman R, Meyboom-de Jong B. Long-term effects of a group support program and an individual support program for informal caregivers of stroke patients: which caregivers benefit the most? Patient Educ Couns. 2002;47(4):291–9. 12135820 · DOI
  34. [37]Sotoudeh R, Pahlavanzadeh S, Alavi M. The effect of a family-based training program on the care burden of family caregivers of patients undergoing hemodialysis. Iran J Nurs Midwifery Res. 2019;24(2):144–50. 30820227 PMC6390430 · DOI
  35. [38]Bartolo 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(26):8176–87. 34913777 · DOI · Paper page
  36. [39]Mirhosseini S, Vaghee S, Nabavi F, Vashani H. Effect of online psychoeducational support on caring burden in family caregivers of COVID-19 patients: a parallel randomized controlled trial. Family Med Prim Care Rev. 2021;23(3):323–9. · DOI
  37. [40]Pihet S, Kipfer S. Coping with dementia caregiving: a mixed-methods study on feasibility and benefits of a psycho-educative group program. BMC Geriatr. 2018;18:1–13. 30200899 PMC6131890 · DOI
  38. [41]Gabriel IO, Mayers PM. Effects of a psychosocial intervention on the quality of life of primary caregivers of women with breast cancer. Eur J Oncol Nurs. 2019;38:85–91. 30717942 · DOI · Paper page
  39. [42]Hayati M, Bagherzadeh R, Mahmudpour M, Heidari F, Vahedparast H. Effect of teaching health-promoting behaviors on the care burden of family caregivers of hemodialysis patients: a four-group clinical trial. BMC Nurs. 2023;22(1):436. 37978371 PMC10655433 · DOI
  40. [43]Alnazly EK. The impact of an educational intervention in caregiving outcomes in Jordanian caregivers of patients receiving hemodialysis: a single group pre-and-post test. Int J Nurs Sci. 2018;5(2):144–50. 31406816 PMC6626206
  41. [44]Zarmohammadi Z, Khatooni M, Ranjbaran M, Hosseinigolafshani SZ. Supporting caregivers of Hemodialysis patients: applying the 5-A self-management model to Alleviate Caregiver Burden. J Nurs Midwifery Sci. 2024;11(2):e144274. · DOI
  42. [45]Frias CE, Garcia-Pascual M, Montoro M, Ribas N, Risco E, Zabalegui A. Effectiveness of a psychoeducational intervention for caregivers of people with dementia with regard to burden, anxiety and depression: a systematic review. J Adv Nurs. 2020;76(3):787–802. 31808211 · DOI
  43. [46]López-Liria R, Vargas-Muñoz E, Aguilar-Parra JM, Padilla-Góngora D, Mañas-Rodriguez MA, Rocamora-Pérez P. Effectiveness of a training program in the management of stress for parents of disabled children. J Child Fam stud. 2020;29:964–77. · DOI
  44. [47]Sari A, Duman ZÇ. Effects of the family support and psychoeducation program based on the Calgary Family Intervention Model on the coping, psychological distress and psychological resilience levels of the family caregivers of chronic psychiatric patients. Arch Psychiatr Nurs. 2022;41:1–10. 36428035 · DOI
  45. [48]Shin JY, Choi SW. Online interventions geared toward increasing resilience and reducing distress in family caregivers. Curr Opin Support Palliat Care. 2020;14(1):60–6. 31842019 PMC6996606 · DOI
  46. [49]Tuckey N, Duncanson E, Chur-Hansen A, Jesudason S. Using an international online forum to explore perspectives of caregivers of patients with chronic kidney disease. J Nephrol 2022:1–11. 35000136
  47. [50]Vaughan C, Trail TE, Mahmud A, Dellva S, Tanielian T, Friedman E. Informal caregivers’ experiences and perceptions of a web-based peer support network: mixed-methods study. J Med Internet Res. 2018;20(8):e257. 30154074 PMC6134228 · DOI · Paper page

Cited by

Sorted by citations

Authors
Khouban-Shargh, R., Mirhosseini, S., Ghasempour, S., Basirinezhad, M. H., & Abbasi, A.
Affiliations
  • Shahroud University of Medical Sciences (IR)
  • Shahid Sadoughi University of Medical Sciences and Health Services (IR)
Corresponding author
Abbasi, Ali
ORCID
Venue
BMC Nephrology
Publisher
Springer Science and Business Media LLC
Published
2024-10-14
Volume
25
Issue
1
Pages
350-350
ISSN
1471-2369 (ISSN-L)
DOI
10.1186/s12882-024-03795-5
PMC
PMC11476389
OpenAlex
W4403395848
Cited by
13
References
1
Citations by year
2026: 6 · 2025: 7
FWCI
8.88
Type
journal article
Language
en
Open access
Licence
Locations
  • BMC Nephrology (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
Funders
Shahroud University of Medical Sciences
Topics
  • Health Sciences › Health Professions › Pharmacy › Nursing care and research
  • Social Sciences › Psychology › Clinical Psychology › Family Caregiving in Mental Illness
  • Health Sciences › Medicine › Nephrology › Dialysis and Renal Disease Management
Keywords
stress management training, caregiver burden, perceived stress, family caregivers, hemodialysis, psychoeducational intervention, online group intervention, Zarit Burden Inventory
MeSH terms
Caregiver Burden, Adult, Aged, Female, Renal Dialysis, Humans, Male, Middle Aged, Stress, Psychological, Caregivers

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review