Middle Eastern Journal of Disability Studies

Abstract
Background & Objectives: Based on the research studies, several psychological interventions are effective for anxiety and stress in dialysis patients. Today, the incidence of kidney disease is increasing. By improving the physical and mental health of people affected by this condition, their physical health can be improved. Chronic kidney failure is one of the diseases that causes many problems in the lives of patients. It seems that one of the factors that can affect the mental health of kidney patients is anxiety and stress in the treatment process, and these two are closely related. And anxiety and stress are among the most common mental disorders that occur after the emergence of stressful events in life, especially chronic diseases, and basically, hemodialysis patients experience a high level of mental tension, anxiety, and depression, and this leads to an increase in malaise, frequent visits to the hospital, the costs and the mortality of the patients will increase. In this regard, this research was conducted to compare the effectiveness of positive thinking and happiness training in reducing anxiety and stress among dialysis patients.
Methods: The research method was quasi–experimental with a pretest–posttest design and a control group. The research population comprised all dialysis patients in Parsabad City, Iran, in 2023. Using the purposive sampling method and in compliance with health protocols, 45 eligible dialysis patients voluntarily participated in the study. They were randomly assigned to two experimental groups (positive thinking and happiness) and one control group (15 participants each). The selection criteria for subjects were having at least six months of undertaking hemodialysis treatment 1–3 times a week, not taking medication for anxiety and stress, lacking psychotic disorders or substance abuse, being at least 20 years old and not more than 55 years old, and having the subject's consent to participate in the study and obtaining written consent. The criteria for subjects to withdraw from the study were unwillingness to continue participating and absence from more than one session of the positive thinking and happiness training. To comply with the ethical principles of research, the confidentiality of participants' information was maintained. Subjects in one experimental group received positive thinking training across 8 sessions, and subjects in the other experimental group received happiness training across 8 sessions. No intervention was performed for the control group. To collect data, the Beck Anxiety Inventory (Beck et al., 1988) and the Perceived Stress Scale (Cohen et al., 1983) were used. Data analysis was performed using descriptive statistics (frequency, percentage, mean, and standard deviation) and inferential statistics, including analysis of covariance and a Bonferroni post hoc test, in SPSS software version 22. The significance level for all tests was set at 0.05.
Results: The results showed that, after controlling for pretest effects, the group effect was significant, and in the two experimental groups (positive thinking and happiness training), the mean scores of anxiety (p<0.001) and stress (p<0.001) were significantly reduced in the posttest compared to the control group. Based on the pairwise comparisons between groups, there was a significant difference in the anxiety and stress variables between the positive thinking training group (p<0.001, p<0.001, respectively) and the happiness training group (p=0.014, p=0.011, respectively), compared with the control group. Still, no significant difference was observed between the two training methods in anxiety (p=0.766) and stress (p=0.586).
Conclusion: Based on the research findings, positive thinking and happiness training are effective in reducing anxiety and stress among dialysis patients, and can be used as appropriate programs to address these problems.