Telephone-adapted mindfulness-based stress reduction (tMBSR) for patients awaiting kidney transplantation: Trial design, rationale and feasibility

针对等待肾移植患者的电话正念减压疗法(tMBSR):试验设计、原理和可行性

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Abstract

BACKGROUND: Mindfulness-based stress reduction (MBSR) has demonstrated benefits for stress-related symptoms; however, for patients with burdensome treatment regimens, multiple co-morbidities and mobility impairment, time and travel requirements pose barriers to MBSR training. PURPOSE: To describe the design, rationale and feasibility results of Journeys to Wellness, a clinical trial of mindfulness training delivered in a novel workshop and teleconference format. The trial aim is to reduce symptoms and improve quality of life in people waiting for a kidney transplant. METHODS: The standard 8-week MBSR program was reconfigured for delivery as two in-person workshops separated in time by six weekly teleconferences (tMBSR). A time and attention comparison condition (tSupport) was created using the workshop-telephone format. FEASIBILITY RESULTS: Kidney transplant candidates (N = 63) were randomly assigned to tMBSR or tSupport: 87% (n = 55) attended ≥ 1 class, and for these, attendance was high (6.6 ± 1.8 tMBSR and 7.0 ± 1.4 tSupport sessions). Fidelity monitoring found that all treatment elements were delivered as planned and few technical problems occurred. Patients in both groups reported high treatment satisfaction, but more tMBSR (83%) than tSupport (43%) participants expected their intervention to be quite a bit or extremely useful for managing their health. Symptoms and quality of life outcomes collected before (baseline, 8 weeks and 6 months) and after kidney transplantation (2, 6 and 12 months) will be analyzed for efficacy. CONCLUSIONS: tMBSR is an accessible intervention that may be useful to people with a wide spectrum of health conditions. Clinicaltrials.gov: NCT01254214.

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