Effects of a Nursing Intervention Based on a Solution-Focused Approach on Renal Transplant Recipients’ Anxiety, Depression, and Quality of Life

Abstract

Objective. To explore the effects of a nursing intervention based on a solution-focused approach on improving renal transplant recipients’ anxiety, depression, and quality of life. Methods. A total of 75 eligible recipients who underwent renal transplantation were recruited and randomly divided into intervention and control groups. The renal transplantation recipients in the intervention group received nursing intervention based on a solution-focused approach (SFA) developed by the research group. The SFA intervention included the following five stages: describing the problem, developing well-formed goals, exploring for exceptions, end of session feedback, and evaluating progress. Additional methods, such as empowerment, miracle questions, and scale mark questions, were included. The intervention began after informed consent, and baseline data were collected at admission, with each participant receiving five interventions lasting 30–60 minutes. The featured methods and five stages of the SFA could be interspersed and used repeatedly. The follow-up was performed at one, three, and six months postoperation. The control group received the usual care of comparable length and follow-up contact. The anxiety, depression, and quality of life of renal transplant recipients were measured and recorded using the Hospital Anxiety and Depression Scale (HADS) and the Quality of Life Scale for Patients of Renal Transplantation (QOL-RT). A trained research nurse collected all the baseline and follow-up data. Results. The baseline information of the patients, such as gender, age, BMI, endogenous creatinine clearance, anxiety, and depression, was similar between the two groups ( $P$  > 0.05). The total scores of HADS (A), HADS (D), and total HADS in both groups showed a downward trend. The intervention group exhibited significantly lower HADS (A) (4.21 ± 1.85) and total HADS scores (7.81 ± 3.31) one month after surgery than the control group in the same period (5.50 ± 2.44 and 9.85 ± 4.19, respectively; $P$  < 0.05). Fewer people in the intervention group had a HADS (A) score ≥8 than those in the control group at one month ( $P$  < 0.05). Depression in the intervention group was significantly lower than that in the control group at three and six months ( $P$  < 0.05). The total QOL-RT scores of the intervention group at one month (126.54 ± 9.62), three months (137.02 ± 7.69), and six months (144.89 ± 7.53) were higher than those of the control group (119.50 ± 11.58, 128.8 ± 10.80, and 138.61 ± 9.09, respectively; $P$  < 0.05). Furthermore, the scores of the physiological function dimensions and treatment dimensions of the QOL-RT in the intervention group were higher than those in the control group at one, three, and six months after the intervention ( $P$  < 0.05). The scores of the social function dimension in the intervention group were higher than those in the control group at three and six months after the intervention ( $P$  < 0.05). Conclusion. Nursing intervention based on the SFA improved anxiety and depression among renal transplant recipients, thereby improving their quality of life.