Examining the acceptability and feasibility of the Compassionate Mindful Resilience (CMR) programme in adult patients with chronic kidney disease: the COSMIC Study
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. Access to psychological and emotional support is not well provided or funded and Kidney Care UK (KCUK) was keen to explore the feasibility of delivering mental health support via virtual means to significantly reach and support more patients with mental wellbeing needs. The aim of this study was to support a new service development project with KCUK by implementing the Compassionate Mindful Resilience (CMR) programme, developed by MindfulnessUK, and explore its feasibility for patients who have chronic kidney disease in stages 4 and 5 or who have received transplants. Methods A multi-method single-group 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 have been a beneficial experience. Discussion The findings suggest that the CMR programme has the potential to improve psychological outcomes among people with advanced kidney disease. The research team are currently developing an application for a randomized controlled trial are required to further test the effectiveness of the CMR programme.
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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 | 0.014 | 0.018 |
| Meta-epidemiology (narrow) | 0.000 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.002 | 0.002 |
| Scholarly communication | 0.002 | 0.001 |
| Open science | 0.001 | 0.003 |
| Research integrity | 0.001 | 0.002 |
| Insufficient payload (model declined to judge) | 0.003 | 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".