The Effectiveness of a Stoicism‐Based Educational Package on Psychological Distress and Self‐Efficacy in Patients Under Hemodialysis: A Randomized Controlled Trial

Abstract

ABSTRACT Background and Aims Patients undergoing hemodialysis face numerous challenges and adversities, which can impact their mental health. Several previous studies have indicated that certain Stoic tenets may be beneficial in alleviating suffering and enhancing mental health outcomes in situations such as chronic disease. Therefore, this study explored the effectiveness of Stoic training in reducing psychological distress and enhancing self‐efficacy among hemodialysis patients. Methods This randomized controlled trial was conducted from February to May 2025. The 8‐week intervention began with virtual Stoic training sessions and transitioned to weekly in‐person meetings. Data were collected using a demographic questionnaire, the Kessler Psychological Distress Questionnaire (K‐10), and the Self‐Efficacy for Managing Chronic Diseases 6‐Item Scale. Data were analyzed using SPSS version 22. Independent t‐tests, χ 2 tests, and multiple linear regression were used for analysis. Results A total of 50 participants (25 in each group) were analyzed. The multiple linear regression model, controlling for baseline scores, hypertension, and education level, showed that the intervention was significantly associated with a reduction in psychological distress (β = 4.75, p = 0.02, 95% CI [8.88, 0.61]) and an increase in self‐efficacy for managing chronic disease (β = 8.76, p = 0.009, 95% CI [2.51, 15.01]). Conclusion The findings suggest that while Stoic training can help alleviate psychological distress, further research is needed to develop an expanded training protocol. This may involve longer practice durations and more scenario‐based exercises to significantly enhance self‐efficacy. Researchers should consider these factors in future studies.