Living well on haemodialysis: Feasibility and acceptability trial of an online Acceptance and Commitment Therapy (ACT) programme for people receiving kidney haemodialysis

Abstract

BackgroundPeople receiving kidney haemodialysis need psychological support. ObjectivesTo assess feasibility and acceptability of a 4-week online video-based Acceptance and Commitment Therapy (ACT) programme for people receiving kidney haemodialysis. DesignSingle group before-and-after study. ParticipantsPeople with end-stage kidney disease currently receiving dialysis, who had received in-centre haemodialysis at least 90 days in the last two years. MeasuresRecruitment, retention and engagement (feasibility); weekly and post-programme feedback (acceptability); pre-intervention and 4-week follow-up (potential outcome measures): kidney disease quality of life (KDQOL-SF), psychological flexibility (Acceptance and Action Scale) and acceptance of illness (Acceptance of Illness Scale). ResultsThe study recruited 13 participants of whom 85% completed at least half the programme and 69% completed the whole programme. Health and medical treatment issues were the main known reasons for non-participation and drop-out. Of the 16 separate elements of the programme (four ‘story’ videos and 12 videos explaining ACT techniques), 13 were positively evaluated by at least 75% of participants. Of 11 aspects of the programme, 8 were positively evaluated by at least 75% of participants, and 89% found the programme easy to use, understood how it worked, found it easy to access, trusted the information, had no technical difficulties, and understood the activities. However, only 66.7% agreed the programme was interesting and only 62.5% agreed they enjoyed the programme. All responding participants indicated they would recommend the programme to people starting dialysis. The direction of change was positive for 17/21 potential outcome measures, with significant (p < 0.05) improvements in psychological flexibility and energy/fatigue. ConclusionsAn online video-based ACT intervention was feasible and acceptable for people receiving kidney haemodialysis and the results provide pilot data for a planned larger trial.