Mental Health

Effects of E-Coach-Based Chronic Disease Management on Self-Management, Quality of Life, and Mental Health in Maintenance Hemodialysis Patients.

Zhang Y, Xing J, et al. • Journal of visualized experiments : JoVE • 2026

PubMed 42921780 DOI 10.3791/74457
TL;DR

The study demonstrates the superior effectiveness of E-Coach, a WeChat-based mini-application, in enhancing self-management behavior, improving quality of life, and alleviating depressive and anxiety symptoms in patients receiving maintenance hemodialysis.

Key Findings

Results

Patients receiving usual care plus E-Coach had significantly higher self-management behavior scores at 6 months than usual care alone, after adjusting for baseline.

  • 96 patients receiving regular maintenance hemodialysis were randomly assigned to usual care (UC) or usual care plus E-Coach.
  • ANCOVA: F(1, 93) = 6.3, p = 0.014, partial η2 = 0.06.
  • Adjusted mean difference was +11.6 (95% CI: 9.7 to 13.6; p < 0.001 by Bonferroni correction).
Results

Self-management scores rose more from baseline to 6 months in the E-Coach group than in the UC group.

  • E-Coach group: mean score increased from 57.1 to 78.3 points (change of +21.2).
  • UC group: mean score increased from 58.6 to 66.5 points (change of +7.9).
  • Between-group difference in change was +13.3 (95% CI: 9.9 to 16.5).
Results

Quality of life, measured with the Kidney Disease Quality of Life-Short Form, improved more in the E-Coach group than in the UC group.

  • The magnitude of score increase from baseline to 6 months was higher in the E-Coach group.
  • The authors interpret this as an improvement in patients' QoL.
Results

Depressive and anxiety symptoms decreased more in the E-Coach group than in the UC group.

  • Measured with the Self-Rating Depression Scale (SDS) and Self-Rating Anxiety Scale (SAS).
  • The E-Coach group had a greater reduction in scores from baseline to 6 months.
Results

The E-Coach group had lower potassium and phosphorus levels than the UC group after 6 months.

  • Laboratory levels were compared at 6 months between groups.
  • This suggests better dietary or medication-related control in the E-Coach group.
Methods

The E-Coach intervention was delivered as a WeChat-based mini-application combining multiple self-management support components.

  • Components: health education, dietary and exercise guidance, medication reminders, and regular online counseling.
  • Content formats included text-based materials, videos, and interactive quizzes.
  • It was added to usual care.

What This Means

This study tested a smartphone-based coaching tool called E-Coach in 96 people receiving long-term hemodialysis for kidney failure. Half received usual care alone, and half received usual care plus E-Coach, a WeChat mini-app offering health education, diet and exercise guidance, medication reminders, and online counseling through text, videos, and quizzes. After 6 months, the E-Coach group reported better self-management of their condition. Their self-management scores rose from 57.1 to 78.3 points, compared with a rise from 58.6 to 66.5 in the usual care group. The E-Coach group also showed greater improvements in quality of life, greater reductions in depression and anxiety symptoms, and lower blood potassium and phosphorus levels. This research suggests that an app-based coaching program may be a useful addition to routine dialysis care for supporting self-management and emotional well-being. The study was relatively small and the abstract reports results from one setting, so the findings would need confirmation in larger and more varied groups of patients.

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Citation

Zhang Y, Xing J, Wang G, Chen Y, Mao D. (2026). Effects of E-Coach-Based Chronic Disease Management on Self-Management, Quality of Life, and Mental Health in Maintenance Hemodialysis Patients.. Journal of visualized experiments : JoVE. https://doi.org/10.3791/74457