Chapter2: Effects Of Mindfulness Meditation On Trait Mindfulness,perceived Stress, Emotion Regulation, Andquality Of Life in Hemodialysis Patients:A Randomized Controlled Trial
Jun 02, 2022
For more info. contact tina.xiang@wecistanche.com
3. Results
3.1. Participants and sociodemographic characteristics
The study flow diagram shows the flow of participants through each stage of the randomized trial(Fig. 1). Table 1 shows the demographic characteristics of the participants in the experimental and control groups and any significant group differences in demographic variables.
Click here to contact the supplier for cistanche where to buy
3.2. Effectiveness of mindfulness mediation
Scores of MAAS, PSS, ERO, and KDQOL-36 of the two groups at T0, T1, and T2 are shown in Table 2. At baseline (TO), independent t-tests were conducted to examine any pretest mean differences between the experimental and control groups based on the dependent variables. The results revealed no significant differences between the experimental and control groups on baseline PSS scores(t=1.117,P=0.268) and ERQscores(t=-0.712,P=0.479).
At the same time, there were statistically significant differences between the experimental and control groups on baseline MAS scores (t=-2.267, P=0.026)and KDQOL-36 scores(t =-2.194, P = 0.031), indicating that trait mindfulness and kidney disease-quality of life of the experimental were lower than those of the control group at baseline.
Table 2 shows the results of repeated measures ANOVA(within-group) tests. In the experimental group, the results revealed that there were significant main effects of time for MAS, ER, and KDQOL but a non-significant main effect of time for PSS. In the control group, the results showed that there were significant main effects of time for MAAS, ER, PSS, and KDQOL. Table 3 shows the results of analyses of variance on dependent variables across three repeated measures for two groups, with significant effects of time by condition interaction for MAAS, ER, PSS, and KDQOL of the two groups.
4. Discussion
The current study results showed significant improvements in perceived stress, mindfulness, emotion regulation, and kidney disease-quality of life scores generally over time and at the end of the intervention.
4.1. Trait mindfulness
In the current study, mindfulness meditation significantly increased MAAS scores over time in the experimental group, as compared to the control group. These findings are consistent with the findings of previous studies. Adamoli et al.(2021)found that in hemodialysis patients, an 8-week mindfulness-based intervention led to greater awareness of body sensations, emotions, and thoughts and greater acceptance of experiences, which are the main attributes of trait mindfulness [13]. In a one-group quasi-experimental study, a mindfulness meditation intervention of 10-20-min sessions received during hemodialysis sessions,3 times a week over 12 weeks, increased mindfulness scores in hemodialysis patients [12]. These results support the theoretical hypothesis claiming that repeated mindfulness-based practices can cultivate and improve the natural mental capacity of mindfulness, called trait mindfulness.
4.2. Perceived stress
In the current study, mindfulness meditation significantly decreased PSS over time in the experimental group compared to the control group. These findings are consistent with those of other studies. In a randomized controlled trial (RCT), patients with chronic renal failure who received an 8-week mindfulness-based intervention during their hemodialysis sessions showed reduced reactivity to stressful situations [13]. Similarly, another RCTused a mindfulness-based stress reduction (MBSR) intervention, adapted to a workshop and teleconference format and found the intervention feasible and effective in reducing symptoms of stress in patients waiting for kidney or pancreas transplant [14]. These results support the theoretical claim that the developed mental capacity of mindfulness enables psychological distance and positive reappraisals, helping to stop initial automatic uncontrollable ap-praisas[9,10].
4.3. Emotion regulation
In the current study, mindfulness meditation significantly increased ER over time in the experimental group, as compared to the control group. These findings are consistent with previous study results. In a three-group pretest-posttest quasi-experimental study conducted among hemodialysis patients, the effectiveness of two months of practicing mindfulness therapy and memory specificity training in improving negative and positive cognitive emotion regulation was greater than the effectiveness of receiving usual care. It has been argued that mindfulness meditation targets the fundamental beliefs and negative thoughts of self-efficacy in patients. It helps hemodialysis patients to change their cognition and makes them aware of their own cognitive and emotional content, which then allows them to explore more appropriate alternatives and stop automatic reactions to stressful situations like hemodialysis[15]. Also, it has been explained that mindfulness meditation can regulate amygdala functioning, a part of the brain's limbic system which is responsible for regulating emotions, such as fear and aggression [28].
4.4. Kidney-disease quality of life
In the current study, mindfulness meditation significantly increased KDQOL over time in the experimental group, while compared with the control group which showed a decreased KDQOL over time. This comes in line with the results of other studies. In a previous RCT, an 8-week MBSR program delivered in a novel workshop-teleconference format, as compared to a telephone-based support group, was more effective in improving HRQ0L in patients awaiting kidney transplantation [14] Another clinical trial demonstrated that eight sessions of mindfulness meditation, as compared to eight educational sessions on end-stage renal disease and hemodialysis, were more effective in improving general health. Mindfulness meditation has been found to decrease physical symptoms, anxiety, depression, sleep disorder, and social dysfunction. A previous experimental study examined the impacts of a mindfulness meditation intervention of 10 to 20-min sessions received during hemodialysis sessions, three times a week over 12 weeks, on physical and psychological health, the main components of HRQOL The intervention was found to improve depressive symptoms, blood pressure values, self-compassion, and serum phosphorous levels.
While hemodialysis increases life expectancy, it poses for patients a wide range of physical, psychological, and social problems which lead to changes in their lifestyle and jeopardize their health-related quality of life over time. The participants in the control group showed a decreased quality of life over time. The findings of this study were consistent with a longitudinal study that showed that the physical and mental functioning of patients with hemodialysis decreased rapidly over time, attributed to increasing co-morbidity. However, mindfulness meditation is designed to increase attention to the body and cultivate awareness of and decrease the automatic interaction of physical, cognitive, and emotional processes, jeopardizing the quality of life.
4.5. Limitations of the study
As a study to evidence the feasibility of mindfulness meditation and its effectiveness on some health outcomes in ESRD patients undergoing hemodialysis, there were some limitations. The use of convenience sampling to recruit a small sample from one setting limits the generalizability of the study findings Therefore, it is recommended that future studies use randomized sampling methods to recruit larger samples from multiple settings. Further, the long-term effects of the intervention were not assessed, and thus, it is recommended that future studies include follow-up assessments. There were significant differences between the study groups regarding the pretest mean scores of trait mindfulness and KDQOL and employment status. These baseline differences may indicate that the simple random assignment method used in this study was not completely successful in equating the two groups on these variables at the pretest. Nevertheless, the differences showed a better condition in the control group than the experimental group at baseline, which would not influence the explanation for the study results. It is recommended that future studies use more effective random assignment methods and procedures. Moreover, even though many techniques were used in this study to avoid contamination bias as mentioned previously, there was no guarantee that contamination would not be found since the participants in the two groups were recruited from the same setting. Thus, it is recommended that future studies use cluster random assignment methods preferably to avoid contamination bias.
4.6. Implications for clinical practice
The findings of the present study indicate that mindfulness meditation is generally effective in improving health outcomes, including perceived stress, trait mindfulness, emotional regulation, and health-related quality of life, among ESRD patients receiving hemodialysis in Kuwait. These positive findings offer a promising tool for patients undergoing hemodialysis as a way to improve their health and quality of life. Mindfulness meditation has been found to be a simple, feasible, and effective stress-reduction technique that can be taught to patients within 30 min [6,10]. Thus, developing and incorporating mindfulness meditation training as a complementary treatment in the care plans of hemodialysis patients may improve the psychological, physical, and social health of these patients.
5. Conclusions
The findings of the current study generally provided preliminary evidence about the effectiveness of mindfulness meditation as a coping tool for end-stage renal disease patients undergoing hemodialysis to manage stress and health in Kuwait. This was evidenced by the decrease in perceived stress and increase in trait mindfulness, emotion regulation, and quality of life among the participants of the experimental group by the end of the intervention.
Overall, the study findings add new knowledge to the stress/coping field that can be used to guide hemodialysis-related clinical practice, education, and healthcare policies in Kuwait and other countries Further studies are needed to investigate the effects of mindfulness meditation on other non-tested health outcomes using random samples recruited from multiple settings, with the inclusion of follow-up assessments of these outcomes.
