The Effectiveness of Dialectical Behavior Therapy on Treatment Adherence, Quality of Life, and Emotion Regulation in Hemodialysis Patients

Ali Ghaderi Dehpahani; Lida Leilabadi; Mehrdad Sabet

Authors

Ali Ghaderi Dehpahani Department of Psychology Ki.c, Islamic Azad University, Kish, Iran. Author https://orcid.org/0000-0001-6856-5874
Lida Leilabadi Department of Psychology, CT.c., Islamic Azad University, Tehran, Iran. https://orcid.org/0000-0001-5702-2620
Mehrdad Sabet Department of Educational Psychology, Ro.c, Islamic Azad University, Roudehen, Iran. Author https://orcid.org/0000-0003-3890-4294

Keywords:

dialectical behavior therapy, emotion regulation, hemodialysis, quality of life, treatment adherence

Abstract

This study aimed to determine the effectiveness of Dialectical Behavior Therapy (DBT) on treatment adherence, quality of life, and emotion regulation in patients undergoing hemodialysis. This quantitative applied study used a quasi-experimental pretest–posttest design with a one-month follow-up and a control group. The statistical population consisted of patients undergoing regular hemodialysis at Shahid Labbafinejad Hospital in Tehran in 2024. Thirty eligible patients were selected through convenience sampling and randomly allocated to an experimental group receiving DBT (n = 15) and a control group (n = 15). The experimental group received eight weekly 90-minute group-based DBT sessions, whereas the control group received no psychological intervention during the study period. Data were collected using the End-Stage Renal Disease Adherence Questionnaire, Kidney Disease Quality of Life Questionnaire, and Gross and John Emotion Regulation Questionnaire. Data were analyzed in SPSS version 26 using mixed-design analysis of variance and Bonferroni-adjusted pairwise comparisons at a significance level of .05. Mixed-design analyses indicated significant effects of time and significant time-by-group interactions for treatment adherence, quality of life, and emotion regulation, showing that changes across pretest, posttest, and follow-up differed significantly between the DBT and control groups (p < .05). Bonferroni-adjusted comparisons showed significantly higher treatment adherence in the DBT group than in the control group (mean difference = 4.20, p = .030), significantly higher quality of life (mean difference = 7.11, p = .010), and significantly better emotion regulation (mean difference = 5.57, p = .001). The intervention effects were largely maintained at the one-month follow-up. DBT appears to be an effective psychological intervention for improving treatment adherence, quality of life, and emotion regulation among patients undergoing hemodialysis, with beneficial effects persisting over the short-term follow-up period.

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