Abstract
The increasing prevalence of people with chronic kidney disease (CKD) undergoing hemodialysis is considered a serious worldwide problem. This population has severe functional, psychological, and social limitations, causing suffering for the patient and high costs for the health system. Studies on Mindfulness-Based Interventions (MBIs) have shown positive effects for various mental and physical disorders. Evidence of the effects of MBIs for people with CKD is emerging and programs carried out during hemodialysis sessions are almost nonexistent. The present experience report aims to describe the Hemomindful Program, an MBI for managing stress and promoting quality of life for people with CKD undergoing hemodialysis. It was an 8-week MBI, performed individually, during the hemodialysis sessions. A total of 15 adults undergoing hemodialysis treatment, 7 women and 8 men, with a mean age of 54 years (SD = 14.9) participated in this study. This report aims to describe the theoretical and practical basis of the Hemomindful Program and how it can contribute to managing stress and promoting quality of life. The participants referred to positive benefits of the practice, such as greater awareness of body sensations, emotions, and thoughts, less reactivity to deal with stressful situations, greater acceptance of experiences, feelings of well-being, changes in eating and fluid consumption habits, improved family relationships, and better self-care.
Resumo
O aumento da prevalência de pessoas com doença renal crônica (DRC) que realizam hemodiálise é crescente, considerado um problema grave a nível mundial. Essa população apresenta muitas limitações funcionais, psicológicas e sociais, gerando sofrimento e custos elevados ao sistema de saúde. Estudos sobre as Intervenções Baseadas em Mindfulness (IBM) apresentam efeitos positivos para de transtornos mentais e físicos. Evidências sobre os efeitos de IBM com pessoas com DRC são incipientes e programas realizados durante as sessões de hemodiálise quase inexistentes. O presente relato de experiência visa descrever o Programa Hemomindful, uma IBM para manejo do estresse e promoção de qualidade de vida de pessoas com DRC em hemodiálise. Trata-se de uma IBM com duração de oito semanas, realizada de forma individual, durante as sessões de hemodiálise. Participaram deste estudo 15 adultos em tratamento de hemodiálise, sendo 7 mulheres e 8 homens, com idade média de 54 anos (DP= 14,9). Este relato procura descrever a base teórica e prática do Programa Hemomindful e como pode contribuir no manejo do estresse e promoção de qualidade de vida. Participantes referem benefícios positivos da prática como: maior consciência de sensações corporais, emoções e pensamentos; menor reatividade para lidar com situações de estresse, maior aceitação das experiências, sensação de bem-estar, mudanças de hábitos alimentares e no consumo de líquidos, melhor relacionamento familiar e autocuidado.
Resumen
El aumento de la prevalencia de personas con enfermedad renal crónica (ERC) que realizan hemodiálisis es creciente y está siendo considerado un problema grave en el ámbito mundial. Esa población presenta graves limitaciones funcionales, sicológicas y sociales, lo que genera sufrimiento y elevados costos en el sistema de salud. Estudios sobre Intervenciones Basadas en Mindfulness (IBM) presentan efectos positivos para trastornos mentales y físicos. Evidencias sobre los efectos de IBM en personas con ERC son incipientes y programas realizados durante las sesiones de hemodiálisis son casi inexistentes. Este relato de experiencia tuvo por objetivo describir el Programa Hemomindful, una IBM para manejo del estrés y promoción de la calidad de vida de personas con ERC experimentando hemodiálisis. Se trata de una IBM con duración de ocho semanas, realizado de forma individual, durante las sesiones de hemodiálisis. Participaron de este estudio 15 adultos en tratamiento de hemodiálisis, siendo 7 mujeres y 8 hombres, con edad media de 54 años (DE= 14,9). Este relato trata de describir la base teórica y práctica del Programa Hemomindful y cómo puede contribuir para la administración del estrés y promoción de la calidad de vida. Los participantes refirieron beneficios positivos de la práctica, como: mayor consciencia de sensaciones corporales, emociones y pensamientos; menor reactividad para lidiar con situaciones de estrés; mayor aceptación de las experiencias; sensación de bienestar; cambios de hábitos alimenticios y no consumo de líquidos; y, mejor relacionamiento familiar y autocuidado.
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Data Availability
The authors declare that all other data supporting the findings of this study are available within the article (and its supplementary information files).
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Acknowledgments
We are immensely grateful to hemodialysis patients with chronic kidney disease who agreed to be part of the study, the care team at the Hemodialysis Unit of the Hospital de Clínicas of Porto Alegre, RS, Brazil, especially the nursing team who went to great lengths for this research to be carried out; to research assistants, collaborators, co-supervisor, and supervisor of this project; to the support of the Research and Graduate Groups of the Hospital de Clínicas de Porto Alegre and the subsidies received by the Fundo de incentivo à pesquisa (FIPE); to the Pontifícia Universidade Católica do Rio Grande do Sul and the Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES); and to everyone who somehow made this study possible.
Funding
This study was funded by the Hospital de Clínicas de Porto Alegre by Fundo de Incentivo à Pesquisa - FIPE (Project number 2019-0017, CAAE: 7493319700005327).
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Substantial contribution to the study concept and design: Angélica Nickel Adamoli, Ana Regina Noto, and Margareth da Silva Oliveira.
Contribution to data collection: Angelica Nickel Adamoli, Bruno Nunes Razzera, Raphaele Nonnenmacher Colferai, and Maitê Freitas Ranheiri.
Contribution to data analysis and interpretation: Angelica Nickel Adamoli, and Bruno Nunes Razzera.
Contribution to the preparation of the manuscript: Angélica Nickel Adamoli, Bruno Nunes Razzera, Raphaele Nonnenmacher Colferai, and Maitê Freitas Ranheiri.
Contribution to critical review adding intellectual content: Angélica Nickel Adamoli, Tamara Anne Russell, Ana Regina Noto, and Margareth da Silva Oliveira.
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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. The study was approved by the Bioethics Committee of the Hospital de Clínicas de Porto Alegre (HCPA) (No. 7493319700005327).
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Adamoli, A.N., Razzera, B.N., Ranheiri, M.F. et al. Mindfulness-Based Intervention Performed During Hemodialysis: an Experience Report. Trends in Psychol. 29, 320–340 (2021). https://doi.org/10.1007/s43076-020-00058-8
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DOI: https://doi.org/10.1007/s43076-020-00058-8