Summary of findings 4. Relaxation techniques versus usual care.
| Relaxation techniques versus usual care for depression in people treated with dialysis | ||||||
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Patient or population: people with ESKD Settings: dialysis Intervention: relaxation techniques1 Comparison: usual care | ||||||
| Outcomes | Illustrative comparative risks* (95% CI) | Relative effect (95% CI) | No. of participants (studies) | Quality of the evidence (GRADE) | Comments | |
| Assumed risk | Corresponding risk | |||||
| Usual care | Relaxation techniques | |||||
| Major depression | No data observations | Not estimable | No observations | Insufficient data observations | Not estimable | Studies were not designed to measure effects of relaxation techniques on major depression |
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Depression (any severity, including mild, moderate and severe depression) Investigators measured depression using the Beck Depression Inventory (BDI). A higher score is indicative of more depressive symptoms. (median follow‐up: 4.2 weeks) |
The mean depression score ranged across control groups from 9.56 to 30.83 | The mean depression score in the intervention group was 5.77 lower (95% CI ‐8.76 to ‐2.78) |
MD ‐5.77 (95% CI ‐8.76 to ‐2.78) |
122 (2) | ⊕⊕⊕⊝ moderate 2 | Relaxation techniques probably decrease depressive symptoms |
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HRQoL Investigators measured health‐related quality of life using the Health Status Questionnaire Short Form (SF‐36) (median follow‐up: 6 weeks) |
Not estimable3 | Not estimable | No observations | Insufficient data observations | Not estimable | Studies were not designed to measure effects of relaxation techniques on HRQoL |
| Anxiety | No data observations | Not estimable | No observations | Insufficient data observations | Not estimable | Studies were not designed to measure effects of relaxation techniques on anxiety |
| Withdrawal from dialysis | No data observations | Not estimable | No observations | Insufficient data observations | Not estimable | Studies were not designed to measure effects of relaxation techniques on withdrawal from dialysis |
| Withdrawal from intervention | No data observations | Not estimable | No observations | Insufficient data observations | Not estimable | Studies were not designed to measure effects of relaxation techniques on withdrawal from intervention |
| Death (any cause) | No data observations | Not estimable | No observations | Insufficient data observations | Not estimable | Studies were not designed to measure effects of relaxation techniques death |
| *The basis for the assumed risk (e.g. the median control group risk across studies) is provided in footnotes. The corresponding risk (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI). ESKD: end‐stage kidney disease; CI: Confidence interval; MD: mean difference; HRQoL: health‐related quality of life | ||||||
| GRADE Working Group grades of evidence High quality: Further research is very unlikely to change our confidence in the estimate of effect. Moderate quality: Further research is likely to have an important impact on our confidence in the estimate of effect and may change the estimate. Low quality: Further research is very likely to have an important impact on our confidence in the estimate of effect and is likely to change the estimate. Very low quality: We are very uncertain about the estimate. | ||||||
1 Relaxation techniques included Benson relaxation technique and nurse‐led breathing training.
2 Studies had high or unclear risks of bias for allocation concealment, blinding of participants or investigators, and blinding of outcome assessment.
3 Treatment effects on HRQoL was not estimable as a single study reported this outcome.