Dataset Information

Experiences of People with Kidney Disease Following the Implementation of the Compassionate Mindful Resilience Programme: Qualitative Findings from the COSMIC Study.

ABSTRACT:

Background

Kidney disease is a progressive, debilitating condition. Patients experience challenging physical and psychological symptoms and are at increased risk of anxiety, depression, and poor mental wellbeing. Access to specialist psychological or social support is limited, with inadequate provision of psychosocial support available across UK renal units. The COSMIC study (examining the acceptability and feasibility of the Compassionate Mindful Resilience programme for adult patients with chronic kidney disease) aimed to support a new service development project, in partnership with Kidney Care UK, by implementing the Compassionate Mindful Resilience (CMR) programme, developed by MindfulnessUK, and explore its feasibility for patients with stage 4 or 5 kidney disease and kidney transplant recipients. This paper reports on the qualitative exploratory work which examined the experiences of study participants, their adherence to practice, and the acceptability of the intervention.

Method

Participants (n = 19) took part in semi-structured interviews, which were transcribed, coded, and thematically analysed.

Results

Three themes (and nine subthemes) were reported: experiences of the CMR programme that facilitated subjective benefit, participants' lived and shared experiences, and the practicalities of CMR programme participation. All participants reported that they found taking part in the CMR programme to be a beneficial experience.

Conclusion

The CMR programme was found to be an acceptable intervention for people living with kidney disease and provided tools and techniques that support the mental health and wellbeing of this patient group. Further qualitative exploration into participant experience should be integrated within future trials of this intervention.

SUBMITTER: Wilson A

PROVIDER: S-EPMC10671038 | biostudies-literature | 2023 Nov

REPOSITORIES: biostudies-literature

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Publications

Experiences of People with Kidney Disease Following the Implementation of the Compassionate Mindful Resilience Programme: Qualitative Findings from the COSMIC Study.

Wilson Anna A McKeaveney Clare C Carswell Claire C Atkinson Karen K Burton Stephanie S McVeigh Clare C Graham-Wisener Lisa L Jääskeläinen Erika E Johnston William W O'Rourke Daniel D Reid Joanne J Rej Soham S Walsh Ian I Noble Helen H

Healthcare (Basel, Switzerland) 20231108 22

<h4>Background</h4>Kidney disease is a progressive, debilitating condition. Patients experience challenging physical and psychological symptoms and are at increased risk of anxiety, depression, and poor mental wellbeing. Access to specialist psychological or social support is limited, with inadequate provision of psychosocial support available across UK renal units. The COSMIC study (examining the acceptability and feasibility of the Compassionate Mindful Resilience programme for adult patients ...[more]

PMID: 37998417

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Project description:BackgroundIndividuals 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.MethodsA 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.ResultsIn 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.ConclusionThe 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.

Project description:BackgroundTelemedicine in the realm of rehabilitation includes the remote delivery of rehabilitation services using communication technologies (eg, telephone, emails, and video). The widespread application of virtual care grants a suitable time to explore the intersection of compassion and telemedicine, especially due to the impact of COVID-19 and how it greatly influenced the delivery of health care universally.ObjectiveThe purpose of this study was to explore how compassionate care is understood and experienced by physiatrists and patients engaged in telemedicine.MethodsWe used a qualitative descriptive approach to conduct interviews with patients and physiatrists between June 2021 and March 2022. Patients were recruited across Canada from social media and from a single hospital network in Toronto, Ontario. Physiatrists were recruited across Canada through social media and the Canadian Association for Physical Medicine and Rehabilitation (CAPM&R) email listserve. Interviews were recorded and transcribed. Data were analyzed thematically.ResultsA total of 19 participants were interviewed-8 physiatrists and 11 patients. Two themes capturing physiatrists' and patients' experiences with delivering and receiving compassionate care, especially in the context of virtual care were identified: (1) compassionate care is inherently rooted in health care providers' inner intentions and are, therefore, expressed as caring behaviors and (2) virtual elements impact the delivery and receipt of compassionate care.ConclusionsCompassionate care stemmed from physiatrists' caring attitudes which then manifest as caring behaviors. In turn, these caring attitudes and behaviors enable individualized care and the establishment of a safe space for patients. Moreover, the virtual care modality both positively and negatively influenced how compassion is enacted by physiatrists and received by patients. Notably, there was large ambiguity around the norms and etiquette surrounding virtual care. Nonetheless, the flexibility and person-centeredness of virtual care cause it to be useful in health care settings.

Project description:IntroductionEach Indian state can select one of the two implementation models under India's National Adolescent Health Strategy, i.e., Rashtriya Kishor Swasthya Karyakram, either direct implementation through the existing State Health Department and systems, or the Non-Governmental Organisation (NGOs) implementation model, which involves partnering with one or more field-level NGOs to provide the services and personnel.MethodsTo compare and comprehend the implementation strategies of the Peer Education programme under the Direct and NGO implementation models within India's National Adolescent Health Strategy, and to document factors facilitating and hindering the adoption and implementation of the programme across two Indian states, using a qualitative approach.ResultsVariations and similarities were seen across the two models. Employing a multi-level selection process, Madhya Pradesh selected two peer educators (PEs), while Maharashtra had four. Criteria included adolescents aged 15 and above in Madhya Pradesh and younger (10-14 years) and older (15-19 years) in Maharashtra. Madhya Pradesh selected Shadow Peers (10-14 years) to address attrition. Training in Madhya Pradesh spanned over 6 days, structured, led by NGO Mentors, utilising standardised, interactive resources with participatory methods. Maharashtra's training, facilitated by Auxiliary Nurse Midwife or Medical Officer, followed traditional approaches and relied on the trainer's expertise. PE session frequency and duration varied from monthly to quarterly. PEs were comfortable in handling issues like nutrition and non-communicable diseases but faced hesitancy in handling sexual and reproductive health issues. Regular Adolescent Friendly Clubs supported peer educators (PEs). In Madhya Pradesh, Adolescent Health and Wellness Days were suspended due to the pandemic, which led to decreased awareness of adolescent health services. Maharashtra resumed Adolescent Health and Wellness Days albeit on a limited scale.ConclusionThe study identified various similarities and deviations from operational guidelines for the implementation of the peer education programme, offering valuable guidance for policymakers, practitioners, and stakeholders involved in RKSK's planning and implementation. It presents actionable strategies to strengthen peer education interventions within national adolescent health programmes, regionally and globally.

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Project description:BACKGROUND:Individual Placement and Support (IPS) is an evidence-based approach to help people with severe mental illness achieve competitive employment. This article provides insight into an organizational and a financial implementation strategy for IPS in the Netherlands by exploring the perceived facilitators and barriers among participating stakeholders. The goal of this multifaceted strategy was to improve IPS implementation by improving the collaboration between all organizations involved, and realising secured IPS funding with a 'pay for performance' element. METHODS:A qualitative, explorative study among practitioners (n = 8) and decision makers (n = 7) in mental health care and vocational rehabilitation was performed using semi-structured interviews to collect rich information about the possible facilitators and barriers with regard to the organizational and financial implementation strategy for IPS. RESULTS:Important perceived facilitators were the key principles of the IPS model, regular meetings of stakeholders in mental health care and vocational rehabilitation, stakeholders' experienced ownership of IPS and collaboration, the mandate and influence of the decision makers involved and secured IPS funding. Important perceived barriers included the experienced rigidity of the IPS model fidelity scale and lack of independent fidelity reviewers, the temporary and fragmented character of the secured funding, lack of communication between decision makers and practitioners and negative attitudes and beliefs among mental health clinicians. Changes in legislation were experienced as a facilitator as well as a barrier. CONCLUSIONS:The results of this study suggest that the collaboration and IPS funding were experienced as improved by applying an organizational and a financial implementation strategy. However, considerable effort is still necessary to overcome the remaining barriers identified and to make the implementation of IPS a success in practice.

Dataset Information

Experiences of People with Kidney Disease Following the Implementation of the Compassionate Mindful Resilience Programme: Qualitative Findings from the COSMIC Study.

Background

Method

Results

Conclusion

Publications

Experiences of People with Kidney Disease Following the Implementation of the Compassionate Mindful Resilience Programme: Qualitative Findings from the COSMIC Study.

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