Development and Preliminary Validation of a Dyadic Psychoeducational Intervention for Hemodialysis Patients and Caregivers Based on the Double ABC-X Model

Objective: To develop and preliminarily validate a dyadic psychoeducational intervention program for maintenance hemodialysis (MHD) patients and their caregivers based on the Double ABC-X Model. Methods: The intervention was constructed by integrating evidence from systematic reviews, cross-sectional survey data (200 MHD patient-caregiver dyads), and a two-round Delphi expert consultation (20 experts). The program, grounded in the Double ABC-X Model, comprised four core modules: (1) disease information provision, (2) social support enhancement, (3) coping strategy training, and (4) relaxation techniques. A pilot trial with three dyads was conducted to assess feasibility and refine the program. Effectiveness was not evaluated in this developmental study. Results: The intervention was designed as a 4-week program with one 30– 40 minute session per week, delivered in face-to-face small groups during pre- or post-dialysis periods. It comprises 4 first-level, 22 second-level, and 10 third-level indicators, organized into four themes: “First Acquaintance”, “Deep Understanding”, “Co - Solution” and “Co - Experience”. Delphi results showed high expert authority (Cr=0.85– 0.86), significant Kendall’s concordance coefficient (P< 0.001), importance scores ≥ 4.35 (5-point scale), and low variation coefficients (≤ 0.12), indicating strong consensus. Conclusion: This study developed a theory-driven, content-validated dyadic psychoeducational intervention for MHD patient-caregiver dyads. Future multicenter randomized controlled trials are needed to validate long-term efficacy. Keywords: Delphi method, double ABC-X model, dyadic psychoeducational intervention, maintenance hemodialysis, program development