Effects of cultural-artistic rehabilitation activities on quality of life, anxiety and depression, and self-management level of maintenance hemodialysis: a propensity-score-matched study

Abstract

Background: Traditional mind-body therapies like Baduanjin, exercise rehabilitation, and psychological support have demonstrated clinical benefits in maintenance hemodialysis (MHD) patients. Although Baduanjin is widely acknowledged for its rehabilitative effects in chronic disease care, its combination with artistic engagement in renal disease treatment remains underexplored. Our study investigates how integrating cultural and physical interventions-targeting physical, psychological, and social health-influences quality of life (QoL), anxiety, depression, and self-management skills in MHD patients.

Methods: We conducted a survey of 109 MHD patients at our hospital's hemodialysis center from February 2024 to March 2025. We administered several questionnaires, including the Renal Disease Quality of Life Short Form 1.3, the Self-Rating Anxiety and Depression Scale, the Chronic Disease Self-Management Questionnaire, and the Hemodialysis Patient Self-Management Scale. The cultural-artistic rehabilitation activities intervention consists of three components: The Artistic Expression Module (poetry/singing), the Modified Baduanjin-Dance Integration and the Group Narrative Therapy. These were delivered in weekly sequences of 60, 90 and 30minutes. Propensity score matching, inverse probability weighting, and linear regression assessed the effects on QoL, psychological symptoms, and self-management.

Results: Following propensity score matching and inverse probability weighting adjustments, the intervention group displayed greater overall QoL scores, kidney-specific QoL improvements, and enhanced self-management abilities relative to controls (P < 0.05). A strong positive association emerged between participation in creative-physical interventions and gains in QoL, mood stabilization, and self-management proficiency.

Conclusion: In MHD patients, integrated cultural-artistic rehabilitation activities enhance quality of life, self-management competence and psychological well-being. These results encourage greater patient engagement in cultural-artistic rehabilitation activities.

Keywords: anxiety and depression; cultural-artistic rehabilitation activities; maintenance hemodialysis; quality of life; self-management.