Effect of Web-Based Psychoeducation on Depression, Anxiety, and Stress Among End-Stage Renal Disease Patients Undergoing Hemodialysis: A Prospective Pre-Post Study

Ira Suarilah; Abu Bakar; Rini Purwanti; Supriyono Supriyono; Nguyen Van Giang

doi:10.30994/jnp.v10i1.671

Authors

Ira Suarilah Faculty of Nursing, Universitas Airlangga, Surabaya,Indonesia https://orcid.org/0000-0001-8234-949X
Abu Bakar Dialysis Unit, Dr. Soetomo General Hospital, Surabaya, Indonesia https://orcid.org/0000-0002-3692-4841
Rini Purwanti Dialysis Unit, Hajj General Hospital, Surabaya, Indonesia https://orcid.org/0009-0003-3197-7244
Supriyono Supriyono Dialysis Unit, Hajj General Hospital, Surabaya, Indonesia https://orcid.org/0009-0003-7363-6560
Nguyen Van Giang Faculty of Nursing, Thai Nguyen University of Medicine and Pharmacy, Thai Nguyen, Vietnam https://orcid.org/0000-0002-3728-3978

DOI:

https://doi.org/10.30994/jnp.v10i1.671

Keywords:

Anxiety, Depression, Digital Health, Hemodialysis, Nephrology Nursing, Stress, Web-Based Psychoeducation

Abstract

Background: Patients with end-stage renal disease (ESRD) undergoing maintenance hemodialysis experience substantial psychological distress, specifically depression, anxiety, and stress. Conventional face-to-face and printed health education are widely used; digital health platforms offer enhanced accessibility and interactive engagement.
Purpose: To examine the effectiveness of web-based psychoeducational intervention among ESRD patients undergoing maintenance hemodialysis.
Methods: A prospective pre-post study design was applied. A total of 60 participants completed the study. The intervention group accessed a web module (15–30 minutes, twice weekly for 8 weeks), the control group received condensed printed booklets. Depression, anxiety, and stress were measured using the validated Indonesian version of the Depression Anxiety Stress Scales (DASS-42). Within-group changes were analyzed using the Wilcoxon signed-rank test, and between-group treatment effects were evaluated using the Mann-Whitney U test.
Results: Both groups demonstrated statistically significant within-group reductions in depression, anxiety, and stress scores. However, between-group comparisons revealed that the web-based intervention yielded significantly lower post-treatment scores than the printed control group across all three domains: depression (Mean 2.13 ± 3.48 vs. 8.60 ± 4.12; p < 0.001, r = 0.68), anxiety (Mean 4.80 ± 3.92 vs. 15.30 ± 5.21; p < 0.001, r = 0.74), and stress (Mean 3.20 ± 3.10 vs. 14.10 ± 4.85; p < 0.001, r = 0.71).
Conclusion: Although both delivery formats contributed to psychological relief, web-based psychoeducation achieved superior efficacy in reducing depression, anxiety, and stress. Interactive digital health platforms represent a highly effective complementary model of care in nephrology nursing.

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