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Akbulut G, Erci B. The effect of conscious mindfulness-based informative approaches on managing symptoms in hemodialysis patients. Front Psychol 2024; 15:1363769. [PMID: 38800673 PMCID: PMC11120957 DOI: 10.3389/fpsyg.2024.1363769] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2023] [Accepted: 04/22/2024] [Indexed: 05/29/2024] Open
Abstract
Introduction The research was conducted to determine the effect of conscious mindfulness based informative approaches applied in hemodialysis patients on reducing stress and managing symptoms. Methods This research was conducted as a real experimental model with a control group. Research population consisted of 160 hemodialysis patients. The sample of the study was determined as 120 hemodialysis patients in total, 60 in the experimental and 60 in the control group, as a result of the power analysis. After the pre-test application, a mindfulness-based stress reduction program was applied to the experimental group. In the analysis of the data collected in the research, percentage, frequency, chi-square analysis, t-test for independent groups, t-test for dependent groups were used by means of SPSS for Windows 22.00 statistical software package. Results The t-test analyses of the differences between pre-test and post-test scores of hemodialysis patients in the experimental group were found to be significant in favor of the post-tests. Discussion It was found out that the conscious mindfulness-based informative approaches decreased the perceived stress and anxiety of the patients in the experimental group, whereas increased their levels of conscious mindfulness and symptom management.
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Affiliation(s)
- Gönül Akbulut
- Aşkale Vocational School, Atatürk University, Erzurum, Turkey
| | - Behice Erci
- Faculty of Nursing, Inönü University, Malatya, Turkey
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Wilson A, Carswell C, McKeaveney C, Atkinson K, Burton S, McVeigh C, Graham-Wisener L, Jääskeläinen E, Johnston W, O'Rourke D, Reid J, Rej S, Walsh I, Noble H. Examining the acceptability and feasibility of the Compassionate Mindful Resilience (CMR) programme in adults living with chronic kidney disease: the COSMIC study findings. BMC Nephrol 2024; 25:45. [PMID: 38297189 PMCID: PMC10832231 DOI: 10.1186/s12882-024-03473-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Accepted: 01/19/2024] [Indexed: 02/02/2024] Open
Abstract
BACKGROUND Individuals with chronic kidney disease experience difficult physical and psychological symptoms, that impact quality of life, and are at increased risk of anxiety and depression. Access to specialist psychological support is limited. This study aimed to support a new service development project, in collaboration with Kidney Care UK, to implement the Compassionate Mindful Resilience (CMR) programme, developed by MindfulnessUK, which provides accessible mindfulness techniques and practices to enhance compassion and resilience, and explore its feasibility for people living with stage 4 or 5 kidney disease and transplant. METHODS A multi-method feasibility design was utilised. Participants over 18 years, from the UK, with stage 4 or 5 kidney disease or post-transplant, and who were not currently undergoing psychotherapy, were recruited to the four-week CMR programme. Data was collected at baseline, post-intervention and three-months post to measure anxiety, depression, self-compassion, mental wellbeing, resilience, and mindfulness. The acceptability of the intervention for a kidney disease population was explored through qualitative interviews with participants, and the Mindfulness Teacher. RESULTS In total, 75 participants were recruited to the study, with 65 completing the CMR programme. The majority were female (66.2%) and post-transplant (63.1%). Analysis of completed outcome measures at baseline and post-intervention timepoints (n = 61), and three-months post intervention (n = 45) revealed significant improvements in participant's levels of anxiety (p < .001) and depression (p < .001), self-compassion (p = .005), mental wellbeing (p < .001), resilience (p.001), and mindfulness (p < .001). Thematic analysis of interviews with participants (n = 19) and Mindfulness Teacher (n = 1) generated three themes (and nine-subthemes); experiences of the CMR programme that facilitated subjective benefit, participants lived and shared experiences, and practicalities of programme participation. All participants interviewed reported that they found programme participation to be beneficial. CONCLUSION The findings suggest that the CMR programme has the potential to improve psychological outcomes among people with chronic kidney disease. Future randomized controlled trials are required to further test its effectiveness.
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Affiliation(s)
- Anna Wilson
- School of Nursing and Midwifery, Queen's University Belfast, Belfast, UK.
| | - Claire Carswell
- School of Nursing and Midwifery, Queen's University Belfast, Belfast, UK
- Department of Health Sciences, University of York, York, UK
| | - Clare McKeaveney
- School of Nursing and Midwifery, Queen's University Belfast, Belfast, UK
| | | | - Stephanie Burton
- School of Nursing and Midwifery, Queen's University Belfast, Belfast, UK
| | - Clare McVeigh
- School of Nursing and Midwifery, Queen's University Belfast, Belfast, UK
| | | | | | - William Johnston
- Patient and Carer Education Partnership, School of Nursing and Midwifery, Queen's University Belfast, Belfast, UK
| | - Daniel O'Rourke
- Patient and Carer Education Partnership, School of Nursing and Midwifery, Queen's University Belfast, Belfast, UK
| | - Joanne Reid
- School of Nursing and Midwifery, Queen's University Belfast, Belfast, UK
| | - Soham Rej
- Department of Psychiatry, McGill University, Montreal, Canada
| | - Ian Walsh
- School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast Northern, Ireland
- Knightsbridge Healthcare Group, Belfast, UK
- Institute of Psychosexual Medicine, London, UK
| | - Helen Noble
- School of Nursing and Midwifery, Queen's University Belfast, Belfast, UK
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Al-Jabi SW. Global research trends and mapping knowledge structure of depression in dialysis patients. World J Psychiatry 2023; 13:593-606. [PMID: 37701544 PMCID: PMC10494777 DOI: 10.5498/wjp.v13.i8.593] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Revised: 06/27/2023] [Accepted: 07/14/2023] [Indexed: 08/17/2023] Open
Abstract
BACKGROUND Depression is one of the most common and important psychological issues faced by dialysis patients. It can make it more difficult for them to adhere to their treatment regimen, which, in turn, can worsen their physical symptoms and lead to poorer health outcomes. AIM To examine the evolution and growth of publications related to dialysis and depression. The objectives were to identify the number of publications, the top active countries, the contributed institutions, funding agencies and journals, as well as to perform citation and research theme analysis. METHODS The search was conducted using the Scopus database for publications related to dialysis and depression between 1970 and 2022. Subsequently, bibliometric analysis was carried out on the data obtained using VOSviewer software, version 1.6.9. This analysis included visualization analysis, co-occurrence analysis and examination of publication trends in dialysis and depression. RESULTS We identified 800 publications that met the search criteria. The number of publications related to dialysis and depression has increased significantly in the past two decades. The USA led the way with 144 publications, which is 18% of all publications on this topic. Turkey came second with 88 publications (11%), followed by China with 55 publications (6.88%) and Iran with 52 publications (6.5%). Analysis of the research theme identified three main clusters related to gender differences in prevalence, identification of depression as a risk factor, and effective interventions to relieve depression. Future research direction analysis shows a shift toward effective interventions to relieve depression in dialysis patients. CONCLUSION This study provides a comprehensive overview of growth, trends and research themes related to dialysis and depression that could help researchers identify gaps in the literature and develop future research.
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Affiliation(s)
- Samah W Al-Jabi
- Department of Clinical and Community Pharmacy, College of Medicine and Health Sciences, An-Najah National University, Nablus 44839, Palestine
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Rigas C, Park H, Nassim M, Su CL, Greenway K, Lipman M, McVeigh C, Novak M, Trinh E, Alam A, Suri RS, Mucsi I, Torres-Platas SG, Noble H, Sekhon H, Rej S, Lifshitz M. Long-term Effects of a Brief Mindfulness Intervention Versus a Health Enhancement Program for Treating Depression and Anxiety in Patients Undergoing Hemodialysis: A Randomized Controlled Trial. Can J Kidney Health Dis 2022; 9:20543581221074562. [PMID: 35273807 PMCID: PMC8902179 DOI: 10.1177/20543581221074562] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Indexed: 11/29/2022] Open
Abstract
Background: Depression and anxiety affect approximately 50% of patients with kidney
failure receiving hemodialysis and are associated with decreased quality of
life and increased risk of hospitalization and mortality. A Brief
Mindfulness Intervention (BMI) may be promising in treating depressive and
anxiety symptoms in this population, but the long-term sustainability of the
intervention’s effects is unknown. Objective: We previously conducted a randomized controlled trial (RCT; n = 55) comparing
an 8-week BMI with an active control (Health Enhancement Program [HEP]) for
patients receiving dialysis, with depression and/or anxiety. Here, we
examine the 6-month follow-up data to determine the long-term sustainability
of BMI versus HEP in reducing (1) depressive symptoms, (2) anxiety symptoms,
and (3) the efficacy of BMI versus HEP in reducing the likelihood of
hospitalization. Design: In this study, we analyzed 6-month follow-up data from an 8-week
assessor-blinded parallel RCT, which evaluated the efficacy of a BMI against
an active control, HEP, in patients receiving hemodialysis with symptoms of
depression and/or anxiety. Setting: The study took place at hemodialysis centers in 4 tertiary-care hospitals in
Montreal, Canada. Participants: Participants included adults aged ≥18 years who were receiving in-center
hemodialysis 3 times per week and had symptoms of depression and/or anxiety
as indicated by a score ≥6 on the Patient Health Questionnaire–9 (PHQ-9)
and/or the General Anxiety Disorder–7 (GAD-7). Methods: Participants were randomized to the treatment arm (BMI) or the active control
arm (HEP) and completed assessments at baseline, 8 weeks, and 6-month
follow-up. Depression was assessed using the PHQ-9, and anxiety was assessed
by the GAD-7. Hospitalization rates were assessed using medical chart
information. Results: We observed significant decrease in depression scores over 6 months in both
BMI and HEP groups, with no significant difference between groups. Anxiety
scores significantly decreased over 6 months, but only in the BMI group.
Brief Mindfulness Intervention and Health Enhancement Program were
comparable in terms of hospitalization rates. Limitations: The limitations of our study include the modest sample size and lack of a
third arm such as a waitlist control. Conclusions: Our results suggest that the beneficial effects of BMI and HEP for improving
mood disorder symptoms in patients receiving dialysis persist at 6-month
follow-up. Both interventions showed sustained effects for depressive
symptoms, but BMI may be more useful in this population given its efficacy
in reducing anxiety symptoms as well. Trial registration: Prior to recruitment, the trial had been registered (ClinicalTrials.gov
Identifier: NCT03406845).
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Affiliation(s)
- Christina Rigas
- Geri-PARTy Research Group, Jewish General Hospital, Montreal, QC, Canada
- Department of Psychiatry, McGill University, Montreal, QC, Canada
| | - Haley Park
- Geri-PARTy Research Group, Jewish General Hospital, Montreal, QC, Canada
- Department of Psychiatry, McGill University, Montreal, QC, Canada
| | - Marouane Nassim
- Geri-PARTy Research Group, Jewish General Hospital, Montreal, QC, Canada
| | - Chien-Lin Su
- Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, QC, Canada
| | - Kyle Greenway
- Department of Psychiatry, McGill University, Montreal, QC, Canada
| | - Mark Lipman
- Division of Nephrology, Jewish General Hospital, Montreal, QC, Canada
- Research Institute of the McGill University Health Center, McGill University, Montreal, QC, Canada
| | - Clare McVeigh
- School of Nursing and Midwifery, Queen’s University, Belfast, UK
| | - Marta Novak
- Department of Psychiatry, University Health Network, University of Toronto, ON, Canada
| | - Emilie Trinh
- Research Institute of the McGill University Health Center, McGill University, Montreal, QC, Canada
- Division of Nephrology, McGill University Health Centre, Montreal, QC, Canada
| | - Ahsan Alam
- Research Institute of the McGill University Health Center, McGill University, Montreal, QC, Canada
- Division of Nephrology, McGill University Health Centre, Montreal, QC, Canada
| | - Rita S. Suri
- Research Institute of the McGill University Health Center, McGill University, Montreal, QC, Canada
- Centre de Recherche du Centre Hospitalier de l’Université de Montréal, QC, Canada
| | - Istvan Mucsi
- Division of Nephrology, McGill University Health Centre, Montreal, QC, Canada
- Transplant Inpatient Unit, Division of Nephrology, University Health Network, Toronto, ON, Canada
- Department of Medicine, University of Toronto, ON, Canada
| | | | - Helen Noble
- School of Nursing and Midwifery, Queen’s University, Belfast, UK
| | - Harmehr Sekhon
- Geri-PARTy Research Group, Jewish General Hospital, Montreal, QC, Canada
- Department of Psychiatry, McGill University, Montreal, QC, Canada
| | - Soham Rej
- Geri-PARTy Research Group, Jewish General Hospital, Montreal, QC, Canada
- Department of Psychiatry, McGill University, Montreal, QC, Canada
| | - Michael Lifshitz
- Department of Psychiatry, McGill University, Montreal, QC, Canada
- Department of Medicine, University of Toronto, ON, Canada
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Alhawatmeh H, Alshammari SM, Rababah JA. Effects of mindfulness meditation on trait mindfulness, perceived stress, emotion regulation, and quality of life in hemodialysis patients: A randomized controlled trial. Int J Nurs Sci 2022; 9:139-146. [PMID: 35509694 PMCID: PMC9052255 DOI: 10.1016/j.ijnss.2022.03.004] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Revised: 02/14/2022] [Accepted: 03/04/2022] [Indexed: 12/19/2022] Open
Abstract
Objective Methods Results Conclusions
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Lavin P, Lesage M, Monroe E, Kanevsky M, Gruber J, Cinalioglu K, Rej S, Sekhon H. Humanoid robot intervention vs. treatment as usual for loneliness in long-term care homes: Study protocol for a pilot randomized controlled trial. Front Psychiatry 2022; 13:1003881. [PMID: 36339874 PMCID: PMC9633865 DOI: 10.3389/fpsyt.2022.1003881] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Accepted: 10/10/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Loneliness affects up to 42% of long-term care residents and is associated with poor health outcomes. Humanoid robot interventions hold promise for reducing loneliness and decreasing barriers to social interaction in long-term care settings, such as the current COVID-19 safety measures in many countries, limited mobility, and poor health. We present a protocol describing an assessor-blinded randomized controlled trial comparing the effects of a humanoid robot intervention to treatment as usual, on loneliness and mental health outcomes in long-term care residents. METHODS Seventy-four (n = 74) older adults experiencing loneliness in 3 long-term care homes will be randomized 1:1 to an 8-week, twice a week social intervention with the Grace humanoid robot vs. a treatment as usual active control. We will assess change (baseline to week 8) in (1) loneliness (primary outcome), (2) depression severity, and (3) stress (secondary outcomes), as well as (4) other exploratory outcomes: anxiety, quality of life and reduction in acute healthcare utilization. We will also assess the feasibility and acceptability of the intervention using qualitative methods. DISCUSSION The proposed study will assess the effects of a social robot on loneliness and other mental health outcomes, as well as the feasibility of the intervention in older adults living in long-term care settings. TRIAL REGISTRATION NCT05423899.
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Affiliation(s)
- Paola Lavin
- Department of Psychiatry, GeriPARTy Research Group, Jewish General Hospital, Montréal, QC, Canada
| | - Myriam Lesage
- Department of Psychiatry, GeriPARTy Research Group, Jewish General Hospital, Montréal, QC, Canada
| | - Edward Monroe
- Awakening Health Limited, Hong Kong, Hong Kong SAR, China
| | - Michael Kanevsky
- CONNECTIN-TeleEmpathy™, Village Medical Center™, Global Health University™, Montréal, QC, Canada
| | - Johanna Gruber
- Department of Psychiatry, GeriPARTy Research Group, Jewish General Hospital, Montréal, QC, Canada
| | - Karin Cinalioglu
- Department of Psychiatry, GeriPARTy Research Group, Jewish General Hospital, Montréal, QC, Canada
| | - Soham Rej
- Department of Psychiatry, GeriPARTy Research Group, Jewish General Hospital, Montréal, QC, Canada.,Department of Psychiatry, Jewish General Hospital, McGill University, Montréal, QC, Canada
| | - Harmehr Sekhon
- Department of Psychiatry, GeriPARTy Research Group, Jewish General Hospital, Montréal, QC, Canada.,Department of Psychiatry, McLean Hospital and Harvard Medical School, Cambridge, MA, United States
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Hornik B, Duława J, Durmała J. Metabolic Syndrome and Psychological Effects of Exercise in Hemodialysis Patients. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:11952. [PMID: 34831708 PMCID: PMC8622865 DOI: 10.3390/ijerph182211952] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/02/2021] [Revised: 11/05/2021] [Accepted: 11/10/2021] [Indexed: 11/16/2022]
Abstract
Metabolic syndrome (MS) and anxiety disorders are common problems among hemodialysis patients (HD). However, there have been no studies defining the role of physical activity in reducing anxiety in HD patients with MS. This study was aimed to determine the effects on the severity of anxiety of a four-week rehabilitation program for HD patients, with or without metabolic syndrome (MS), planned and adapted to their abilities. The study was single-center, interventional, non-randomized, and prospective. Fifty-eight individuals completed the project (28 HD patients and 30 controls (C) with normal kidney function). Each group was divided into two subgroups with respect to MS. The mean age of the subjects in the HD and C groups was 56.9 ± 13.3 years (x¯ ± SD) and 61.5 ± 8.3 years (x¯ ± SD), respectively. Planned and adapted to the patient's abilities, the rehabilitation program based on physiotherapy was provided to each subject for 4 weeks. Baseline and post-intervention determined anxiety levels using the State-Trait Anxiety Inventory (STAI). The X1 scale tests state anxiety, and the X2 scale tests trait anxiety. Post-intervention, there was no significant difference in the intensity of state anxiety observed in HD patients compared to C with normal renal function, as observed before the program. After four weeks of regular physical activity planned and adapted to the patient's abilities in an inpatient ward, the level of state anxiety (X1) and trait anxiety (X2) lowered considerably in all HD patients (respectively: 35.1 ± 8.0 vs. 29.2 ± 5.0, p = 0.001 for X1 and 41.8 ± 9.1 vs. 38.1 ± 5.9, p = 0.008 for X2). The rehabilitation program significantly reduced the intensity of state anxiety (X1) in HD patients with MS (35.8 ± 7.9 vs. 29.2 ± 5.1; p = 0.01). The rehabilitation program helped to significantly reduce the intensity of trait anxiety (X2) in HD patients without MS (41.9 ± 10.7 vs. 36.9 ± 5.9; p = 0.04). Four-week physical activity planned and adapted to the patient's abilities reduces the intensity of anxiety in HD patients and controls with normal renal function. HD patients with MS benefit more in terms of reducing perceived state anxiety, and HD patients without MS in terms of reducing trait anxiety.
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Affiliation(s)
- Beata Hornik
- Department of Internal Nursing, School of Health Sciences in Katowice, Medical University of Silesia, 40-752 Katowice, Poland
| | - Jan Duława
- Department of Internal Medicine and Metabolic Diseases, School of Health Sciences in Katowice, Medical University of Silesia, 40-752 Katowice, Poland;
- Diaverum, 40-635 Katowice, Poland
| | - Jacek Durmała
- Department of Rehabilitation, School of Health Sciences in Katowice, Medical University of Silesia, 40-752 Katowice, Poland;
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Do Brief Mindfulness Interventions (BMI) and Health Enhancement Programs (HEP) Improve Sleep in Patients in Hemodialysis with Depression and Anxiety? Healthcare (Basel) 2021; 9:healthcare9111410. [PMID: 34828457 PMCID: PMC8621877 DOI: 10.3390/healthcare9111410] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Revised: 09/22/2021] [Accepted: 10/11/2021] [Indexed: 11/18/2022] Open
Abstract
(1) Objective: to determine if a brief mindfulness intervention (BMI) and a health education program (HEP) could improve measures of insomnia in patients undergoing hemodialysis. (2) Methods: this was a planned secondary analysis of a randomized controlled trial of BMI vs. HEP for hemodialysis patients with depression and/or anxiety symptoms. The primary outcome for the analysis was the Athens Insomnia Scale (AIS). The secondary outcome was consolidation of daily inactivity (ConDI), an actigraphy measure that describes sleep continuity and is based on a sleep detection algorithm validated by polysomnography. We also explored whether changes in AIS and ConDI were associated with changes in depression, anxiety, and quality of life scores over 8-week follow-up. (3) Results: BMI and HEP groups did not differ significantly from one another. Exposure to BMI or HEP improved sleep quality (baseline AIS 9.9 (±5.0) vs. 8-week follow-up 6.4 (±3.9), (V = 155.5, p = 0.015)), but not ConDI. Improvements in AIS were associated with lower depression scores (Rho = 0.57, p = 0.01) and higher quality-of-life scores (Rho = 0.46, p = 0.04). (4) Conclusions: mindfulness and HEP may be helpful interventions to improve self-reported sleep quality in patients undergoing hemodialysis. Decreases in insomnia scores were associated with decreased depression symptoms and increased quality of life scores.
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Salvado M, Marques DL, Pires IM, Silva NM. Mindfulness-Based Interventions to Reduce Burnout in Primary Healthcare Professionals: A Systematic Review and Meta-Analysis. Healthcare (Basel) 2021; 9:healthcare9101342. [PMID: 34683022 PMCID: PMC8544467 DOI: 10.3390/healthcare9101342] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2021] [Revised: 10/05/2021] [Accepted: 10/06/2021] [Indexed: 01/23/2023] Open
Abstract
Mindfulness-based interventions (MBIs) are reported by experimental studies as practical approaches to reduce burnout in primary healthcare professionals (PHCP). However, to date, no research has synthesized the evidence to determine the overall effects of MBIs for reducing burnout in PHCP. We conducted a systematic review and meta-analysis to analyze the effects of MBIs to reduce burnout in PHCP. We searched articles in the PubMed/MEDLINE, Web of Science, Cochrane, and Scopus databases from inception to September 2021 using MeSH terms: "mindfulness", "burnout", and "primary healthcare". Two reviewers extracted the data and assessed the risk of bias. We used a random-effects meta-analysis to calculate the standardized mean differences (SMD) and mean differences (MD) with 95% confidence intervals (CI) of emotional exhaustion (EE), depersonalization (DP), and personal accomplishment (PA) domains of burnout. Of 61 records, ten were included (n = 417). Overall, the studies were rated as having a high risk of bias and limited quality evidence. MBIs significantly reduced EE (SMD = -0.54, 95%CI: -0.72 to -0.36; MD = -5.89, 95%CI: -7.72 to -4.05), DP (SMD = -0.34, 95%CI: -0.52 to -0.17; MD = -1.96, 95%CI: -2.96 to -0.95), and significantly increased PA (SMD = 0.34, 95%CI: 0.17 to 0.52; MD = 2.05, 95%CI: 1.04 to 3.06). Although further high-quality research is needed, our findings support the implementation of MBIs for reducing burnout in PHCP.
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Affiliation(s)
- Mafalda Salvado
- Centro de Saúde Dr. Gorjão Henriques, Unidade de Saúde Familiar Cidade do Lis, 2410-272 Leiria, Portugal;
- Correspondence:
| | - Diogo Luís Marques
- Department of Sport Sciences, University of Beira Interior, 6201-001 Covilhã, Portugal;
| | - Ivan Miguel Pires
- Instituto de Telecomunicações, Universidade da Beira Interior, 6200-001 Covilhã, Portugal;
- Escola de Ciências e Tecnologias, University of Trás-os-Montes e Alto Douro, Quinta de Prados, 5001-801 Vila Real, Portugal
| | - Nádia Mendes Silva
- Centro de Saúde Dr. Gorjão Henriques, Unidade de Saúde Familiar Cidade do Lis, 2410-272 Leiria, Portugal;
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Griva K, Chia JMX, Goh ZZS, Wong YP, Loei J, Thach TQ, Chua WB, Khan BA. Effectiveness of a brief positive skills intervention to improve psychological adjustment in patients with end-stage kidney disease newly initiated on haemodialysis: protocol for a randomised controlled trial (HED-Start). BMJ Open 2021; 11:e053588. [PMID: 34548369 PMCID: PMC8458344 DOI: 10.1136/bmjopen-2021-053588] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Accepted: 08/04/2021] [Indexed: 12/02/2022] Open
Abstract
INTRODUCTION Initiation onto haemodialysis is a critical transition that entails multiple psychosocial and behavioural demands that can compound mental health burden. Interventions guided by self-management and cognitive-behavioural therapy to improve distress have been variably effective yet are resource-intensive or delivered reactively. Interventions with a focus on positive affect for patients with end-stage kidney disease are lacking. This study will seek (1) to develop a positive life skills intervention (HED-Start) combining evidence and stakeholder/user involvement and (2) evaluate the effectiveness of HED-Start to facilitate positive life skills acquisition and improve symptoms of distress and adjustment in incident haemodialysis patients. METHODS AND ANALYSIS This is a single/assessor-blinded randomised controlled trial (RCT) to compare HED-Start to usual care. In designing HED-Start, semistructured interviews, a codesign workshop and an internal pilot will be undertaken, followed by a two-arm parallel RCT to evaluate the effectiveness of HED-Start. A total of 148 incident HD patients will be randomised using a 1:2 ratio into usual care versus HED-Start to be delivered in groups by trained facilitators between January 2021 and September 2022. Anxiety and depression will be the primary outcomes; secondary outcomes will be positive and negative affect, quality of life, illness perceptions, self-efficacy, self-management skills, benefit finding and resilience. Assessments will be taken at 2 weeks prerandomisation (baseline) and 3 months postrandomisation (2 weeks post-HED-Start completion). Primary analyses will use an intention-to-treat approach and compare changes in outcomes from baseline to follow-up relative to the control group using mixed-effect models. ETHICS AND DISSEMINATION Ethics approval was obtained from Nanyang Technological University Institutional Review Board (IRB-2019-01-010). Written informed consent will be obtained before any research activities. Trial results will be disseminated via publications in peer-reviewed journals and conference presentations and will inform revision(s) in renal health services to support the transition of new patients to haemodialysis. TRIAL REGISTRATION NUMBER NCT04774770.
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Affiliation(s)
- Konstadina Griva
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore
| | - Jace Ming Xuan Chia
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore
| | | | | | - Job Loei
- National Kidney Foundation Singapore, Singapore
| | - Thuan Quoc Thach
- Department of Psychiatry, The University of Hong Kong, Hong Kong, China
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