Effect of Benson's Relaxation on Physical, Psychological, and Quality of Life Outcomes in Adults Receiving Hemodialysis: Systematic Review and Meta-Analysis.

BACKGROUND

Adults receiving hemodialysis experience many problems. Benson's relaxation technique has been used to manage these problems, but evidence of its effectiveness is limited.

OBJECTIVES

To assess Benson's relaxation effects on physical, psychological outcomes, and quality of life in adults receiving hemodialysis.

DESIGN

Systematic review and meta-analysis of randomized controlled trials registered in PROSPERO (CRD42022379551).

PARTICIPANTS

Adults receiving hemodialysis.

MEASUREMENTS: Eleven databases were searched through January 18, 2024, and updated January 10, 2025. Eligible RCTs involved adults on hemodialysis for at least 3 months, comparing Benson's relaxation with routine care or other interventions. Primary outcomes included physical measures, quality of life, and psychological outcomes; secondary outcomes were narratively reported. Risk of bias was assessed with Cochrane RoB 2.0, and evidence certainty with GRADE. Random-effects meta-analysis and sensitivity analyses used Comprehensive Meta-Analysis v3.

RESULTS

Fourteen trials with 1,104 participants provided low-certainty evidence for small effects on serum phosphate (Hedges' g = 0.39, p = 0.010) and large effects on pain (Hedges' g = 1.21, p = 0.010). Very-low-certainty evidence found moderate effects on quality of life (Hedges' g = 0.65, p = 0.010) and large effects on stress (Hedges' g = 1.58, p = 0.017). High-certainty evidence showed small effects on anxiety (Hedges' g = 0.45, p = 0.001). No significant effects were observed for serum calcium or depression symptoms. Sensitivity analyses showed variable robustness. Secondary outcomes were reported narratively.

CONCLUSIONS

Overall, current evidence supports cautious clinical interpretation and highlights the need for further rigorous, adequately powered randomized controlled trials.

STUDY REGISTRATION: This study is registered in PROSPERO (Registration Number: CRD42022379551, registered on December 8, 2022).