69 The Compassionate Mindful Resilience (CMR) programme for people with kidney disease
Bibliographic record
Abstract
Introduction People with advanced kidney disease face multiple challenges associated with the disease and renal replacement therapy such as increased anxiety and depression, and access to psychological support is not well provided. Aim The study aimed to support a new service development project, in collaboration 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. Methods A multi-method feasibility design was utilised. Participants (n=75) 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 study and participated in the four-week CMR programme. Data was collected at baseline, post-intervention and at three-months post to measure anxiety, depression, self-compassion, mental wellbeing, resilience, and mindfulness. Qualitative interviews were conducted with participants and the Mindfulness Teacher to explore the feasibility and acceptability of the intervention for a kidney disease population. Results In total, 65 participants completed 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 at three-months post intervention (n=45) revealed significant improvements in participant’s levels of anxiety and depression, self-compassion, mental wellbeing, resilience, and mindfulness. Thematic analysis of participant interviews (n=19) and the Mindfulness Teacher (n=1) identified three themes (and nine-subthemes); experiences of the CMR programme that facilitated subjective benefit, participants lived and shared experiences, and practicalities of CMR programme participation. All participants interviewed reported that they found participating in the CMR programme to be beneficial. Conclusion and Impact The findings suggest that the CMR programme has the potential to improve psychological outcomes among people with advanced kidney disease. Future randomized controlled trials are required to further test its effectiveness. References Kidney Care UK and National Psychosocial Working Group: Psychosocial Health – A Manifesto for Action; 2022 Donahue S, Quinn DK, Cukor D, Kimmel PL. Anxiety presentations and treatments in populations with kidney disease. Semin Nephrol. 2021;41(6):516–25. Tsai Y-C, Chiu Y-W, Hung C-C, Hwang S-J, Tsai J-C, Wang S-L, et al. Association of symptoms of depression with progression of CKD. American Journal of Kidney Diseases. 2012;60(1):54–61. Bennett P, Ngo T, Kalife C, Schiller B. Improving wellbeing in patients undergoing dialysis: Can meditation help? Seminars in Dialysis, 2018;3:59–64
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.004 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.005 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".