The Effect of a Family‑Based Training Program on the Care Burden of Family Caregivers of Patients Undergoing Hemodialysis

Reza Sotoudeh, Saeid Pahlavanzadeh, Mousa Alavi


Background: The family caregivers of patients undergoing hemodialysis are faced with multiple physical, psychological, social, economic, and spiritual problems that increase their care burden. The present study was conducted to determine the effects of a family‑based training program on the care burden of family caregivers of patients undergoing hemodialysis.

Materials and Methods: The present controlled, randomized, clinical trial was conducted on 70 caregivers of patients undergoing hemodialysis in Ali Asghar and Zahray‑e Marzieh hospitals in Isfahan, Iran, in 2017. After conducting convenient sampling, 70 participants were randomly assigned into 2 groups (35 in each group). The experimental group received the family‑based training program and the control group received usual care plan. Data were collected using the Zarit Burden Scale before, immediately after, and 1 month after the intervention and were then analyzed by independent t‑test, Chi‑square, and Analysis of Covariance (ANCOVA) repeated measure.

Results: The results showed that both groups were homogeneous in terms of their demographic data and showed no significant differences. The main effect of group was significant, indicating a significant decrease in care burden in the experimental group after the intervention (F 1,67 = 1089, p < 0.001). However, the interaction of time and group was not significant, indicating insignificant difference in burden 1 month after intervention (p > 0.05).

Conclusions: Since the family‑based training program successfully reduced the burden of care immediately after intervention, similar family‑based training programs are recommended to be designed and developed. However, insignificant time effect suggests further researches of long time effects of such program.


Burden,family‑based training,family caregivers,hemodialysis,Iran

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Centers for Disease Control and Prevention. National Diabetes Statistics Report, 2017. Atlanta, GA: Centers for Disease Control and Prevention, US Department of Health and Human Services; 2017.

Singh AK, Farag YM, Mittal BV, Subramanian KK, Reddy SRK, Acharya VN, et al. Epidemiology and risk factors of chronic kidney disease in India–results from the SEEK (Screening and Early Evaluation of Kidney Disease) study. BMC Nephrol 2013;14:114.

Matsha TE, Yako YY, Rensburg MA, Hassan MS, Kengne AP, Erasmus RT. Chronic kidney diseases in mixed ancestry south African populations: Prevalence, determinants and concordance between kidney function estimators. BMC Nephrol 2013;14:75.

Khorami‑Markani A, Khalkhali HR, Sakhaei SH, Saheli S. Assessment the effect of family centered care educational program on home care knowledge among care givers of patients with chronic renal failure under hemodialysis. J Urmia Nurs Midwifery Fac 2015;13:386‑94. (Persian).

Naji A, Naroie S, Abdeyazdan G, Dadkani E. Effect of applying self‑care orem model on quality of life in the patient under hemodialysis. Zahedan J Res Med Sci 2012;14:8‑12. (Persian).

Talebi M, Mokhtari Lakeh N, Rezasoltani P. Caregiver burden in caregivers of renal patients under hemodialysis. J Holist Nurs Midwifery 2016;25:59‑68. (Persian).

Ebrahimi H, Ashrafi Z, Eslampanah G, Noruzpur F. Relationship between spiritual well‑being and quality of life in hemodialysis patients. J Nurs Midwifery Sci 2014;1:41‑8. (Persian).

Mousavi SS, Soleimani A, Mousavi MB. Epidemiology of end stage renal disease in Iran: A review article. Saudi J Kidney Dis Transpl 2014;25:697‑702.

Haririan HR, Aghajanlo A, Ghafurifard M. Evaluation of social support level among hemodialysis patients in the hospitals of Zanjan. Med Sci J Islamic Azad Univesity‑Tehran Med Branch 2013;23:74‑80. (Persian).

Abbasi A, Asayesh H, Rahmani H, Shariati A, Hosseini S, Rouhi G. The burden on cargivers from hemodialysis patients and related factors. J Res Development Nurs Midwifery 2011;8:26‑33. (Persian).

Lomba L, Lameirinhas A, Silva AM, Brito J. Impact of peritoneal dialysis on the family life of children with chronic kidney disease: Integrative literature review. Revista de Enfermagem Referência 2014;4:139‑48.

Alnazly EK. Burden and coping strategies among Jordanian caregivers of patients undergoing hemodialysis. Hemodial Int 2016;20:84‑93.

Jadhav BS, Dhavale HS, Dere SS, Dadarwala DD. Psychiatric morbidity, quality of life and caregiver burden in patients undergoing hemodialysis. Med J Dr DY Patil Vidyapeeth 2014;7:722‑7.

Bayoumi MM. Subjective burden on family carers of hemodialysis patients. Open J Nephrol 2014;4:79‑85.

Mollaoğlu M, Kayataş M, Yürügen B. Effects on caregiver burden of education related to home care in patients undergoing hemodialysis. Hemodial Int 2013;17:413‑20.

Rioux JP, Narayanan R, Chan CT. Caregiver burden among nocturnal home hemodialysis patients. Hemodial Int 2012;16:214‑9.

Akbari M, Alavi M, Maghsoudi J, Irajpour A, Lopez V, Cleary M. Mastering the Art of Collaboration: Supporting Family Caregivers of Mental Health Patients by Service Providers in Iran. Adm Policy Ment Health. 2018. doi: 10.1007/ s10488‑018‑0893‑7.

Pahlavanzadeh S, Heidari FG, Maghsudi J, Ghazavi Z, Samandari S. The effects of family education program on the caregiver burden of families of elderly with dementia disorders. Iran J Nurs Midwifery Res 2010;15:102‑8

Etemadifar S, Bahrami M, Shahriari M, Farsani AK. The effectiveness of a supportive educative group intervention on family caregiver burden of patients with heart failure. Iran J Nurs Midwifery Res 2014;19:217‑23.

Navidian A, Pahlavanzadeh S, Yazdani M. The effectiveness of family training on family caregivers of inpatients with mental disorders. Iran J Psychiatr Clin Psychol 2010;16:99‑106. (Persian).

Carretero S, Garcés J, Ródenas F, Sanjosé V. The informal caregiver’s burden of dependent people: Theory and empirical review. Arch Gerontol Geriatr 2009;49:74‑9.

Ducharme F, Dubé V, Lévesque L, Saulnier D, Giroux F. An online stress management training program as a supportive nursing intervention for family caregivers of an elderly person. Can J Nurs Inform 2011;6:1‑22.

Masoodi R, Alhani F, Moghadassi J, Ghorbani M. The effect of family‑centered empowerment model on skill, attitude, and knowledge of multiple sclerosis caregivers. J Birjand Univ Med Sci 2010;17:87‑97. (Persian).

Pahlavanzade S, Khosravi N, Moeini M. The effect of a family need‑based program on burden of caregivers of leukemia patients in Isfahan in 2013‑2014. Iran J Nurs Midwifery Res 2014;19:629‑34.

Bagherbeig Tabrizi L, Navab E, Farokhnezhad Afshar P, Asadi Noghabi A, Haghani H. Effect of cognitive‑behavioral intervention on burden of family caregivers of patients with alzheimer’s disease. Hayat 2015;21:94‑102.

Zarit SH, Reever KE, Bach‑Peterson J. Relatives of the impaired elderly: Correlates of feelings of burden. Gerontologist 1980;20:649‑55.

Navidian A, Kermansaravi F. Evaluation of psychological stress family caregivers of psychiatric patients admitted to hospital in Zahedan Psychiatric Center. J Med Purif 2012;2:1383. (Persian).

Grunnfeld E, Coyle D, Whelan T, Clinch J, Reyno L, Willan A, et al. Family caregiver burden: Result of longitudinal study of breast cancer patients and their principal caregivers. CAMJ 2004;170:1795‑801.

Bahrami M, Farzi S. The effect of a supportive educational program based on COPE model on caring burden and quality of life in family caregivers of women with breast cancer. Iran J Nurs Midwifery Res 2014;19:119‑26.

Mousavi S, Pahlavanzadeh S, Mehrabi T. The effect of Barkley’s family‑oriented program on the burden of care on families of children with attention deficit‑hyperactive disorder. Iran J Nurs Midwifery Res 2017;22:123‑7.

Belgacem B, Auclair C, Fedor M‑C, Brugnon D, Blanquet M, Tournilhac O, et al. A caregiver educational program improves quality of life and burden for cancer patients and their caregivers: A randomised clinical trial. Eur J Oncol Nurs 2013;17:870‑6.

Martín‑Carrasco M, Martín MF, Valero CP, Millán PR, García CI, Montalbán SR, et al. Effectiveness of a psychoeducational intervention program in the reduction of caregiver burden in Alzheimer’s disease patients’ caregivers. Int J Geriatr Psychiatry 2009;24:489‑99.

McMillan SC, Small BJ, Weitzner M, Schonwetter R, Tittle M, Moody L, et al. Impact of coping skills intervention with family caregivers of hospice patients with cancer. Cancer 2006;106:214‑22.


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