Feasibility of the Hemomindful Program: a mindfulness-based program performed during hemodialysis

J Bras Nefrol. 2025 Jan-Mar;47(1):e20240068. doi: 10.1590/2175-8239-JBN-2024-0068en.
[Article in English, Portuguese]

Abstract

Introduction: Recent evidence indicates that mindfulness-based programs (MBPs) improve overall well-being and the ability to cope with kidney failure and hemodialysis stressors. However, intradialytic MBPs are poorly investigated.

Objective: The aim of this study was to describe the study protocol, evaluate the feasibility and perceived effects of the Hemomindful Program.

Methods: The results presented are from a mixed-methods randomized controlled trial. Thirty-two adults with kidney failure were randomized into the Hemomindful Program, which consisting of 8 weekly individual sessions of 1 hour delivered at chairside during hemodialysis combined with the treatment as usual (TAU), or TAU alone. Feasibility was assessed based on retention of the study protocol, adherence to the Hemomindful Program, its safety, and participant satisfaction. Semi-structured interviews were conducted with participants in the intervention arm immediately following treatment. Data were analyzed using descriptive statistics and discursive textual analysis.

Results: The overall rate of adherence to the study protocol was 84.38%. Among the participants in the Hemomindful Program (n = 16), 15 had four or more sessions (93.7%) and 12 completed the protocol (75%). Degree of importance attributed to the intervention was 8.58 (SD = 2.06) and intention to maintain the formal and informal mindfulness practices after the intervention was 6.67 (SD = 2.93) and 8.5 (SD = 2.31). The qualitative analysis indicated satisfaction with the perceived changes (greater awareness in daily activities, less reactivity, management of pain and discomfort) and the structure of the program.

Conclusion: The Hemomindful Program showed positive indicators of feasibility, with good retention, acceptability and safety.

Introdução:: egundo evidências recentes, os programas baseados em mindfulness (PBM) melhoram o bem-estar geral e a capacidade de lidar com a insuficiência renal e os fatores de estresse na hemodiálise. Entretanto, PBM intradialíticos são pouco investigados.

Objetivo:: Descrever o protocolo do estudo, avaliar a viabilidade e efeitos percebidos do Programa Hemomindful.

Métodos:: Os resultados apresentados são de um ensaio clínico randomizado de métodos mistos. Trinta e dois adultos com insuficiência renal foram randomizados para o Programa Hemomindful, que consiste em 8 sessões individuais semanais de 1 hora realizadas na cadeira durante a hemodiálise, combinadas com o tratamento usual (TAU), ou TAU isolado. A viabilidade foi avaliada conforme retenção do protocolo, adesão ao Programa Hemomindful, sua segurança e satisfação do participante. Realizamos entrevistas semiestruturadas com participantes do braço de intervenção imediatamente após o tratamento. Dados foram analisados utilizando estatísticas descritivas e análise textual discursiva.

Resultados:: A taxa geral de adesão ao protocolo foi de 84,38%. Entre os participantes do Programa (n = 16), 15 realizaram quatro ou mais sessões (93,7%) e 12 completaram o protocolo (75%). O grau de importância atribuído à intervenção foi 8,58 (DP = 2,06) e a intenção de manter as práticas formais e informais de mindfulness após a intervenção foi 6,67 (DP = 2,93) e 8,5 (DP = 2,31). A análise qualitativa indicou satisfação com as mudanças percebidas (maior consciência nas atividades diárias, menor reatividade, manejo da dor e desconforto) e com a estrutura do programa.

Conclusão:: O Programa Hemomindful apresentou indicadores positivos de viabilidade, com boa retenção, aceitabilidade e segurança.

MeSH terms

  • Adult
  • Aged
  • Clinical Trial Protocols as Topic
  • Feasibility Studies*
  • Female
  • Humans
  • Kidney Failure, Chronic / psychology
  • Kidney Failure, Chronic / therapy
  • Male
  • Middle Aged
  • Mindfulness* / methods
  • Patient Satisfaction
  • Randomized Controlled Trials as Topic
  • Renal Dialysis* / psychology