The Effect of Mindfulness-Based Nursing Interventions Applied to Hemodialysis Patients on Psychological Well-Being and Treatment Adherence

Chronic kidney disease (CKD) and its treatment with hemodialysis pose significant challenges to patients' psychological well-being and adherence to complex treatment regimens. This randomized controlled trial investigated the effects of nurse-led, mindfulness-based interventions on psychological well-being and treatment adherence in patients undergoing hemodialysis. Eighty patients from a single dialysis center in Türkiye were randomly assigned to either an intervention group (n = 40) receiving six weekly mindfulness sessions or a control group (n = 40) receiving routine care. Data were collected using the Mindful Attention Awareness Scale (MAAS), the Psychological Well-Being Scale (PWB), and the End-Stage Renal Disease Adherence Questionnaire (ESRD-AQ) at baseline and post-intervention. Mixed-design analyses revealed significant improvements in mindfulness, psychological well-being, and all subscales of treatment adherence-including hemodialysis attendance, medication adherence, fluid management, and dietary compliance-in the intervention group compared to the control group (p < 0.001). Moderate to large effect sizes (Cohen's d = 0.36-1.70) indicate clinically meaningful changes. Pearson correlation analysis demonstrated a positive association between psychological well-being and treatment adherence (r = 0.302, p < 0.01). These findings suggest that structured, nurse-delivered mindfulness programs can simultaneously enhance psychosocial outcomes and adherence behaviors in hemodialysis patients. Integrating mindfulness-based interventions into routine nursing care may provide dual benefits by promoting emotional well-being and supporting self-regulated adherence to treatment regimens. Future research should explore long-term effects, broader patient populations, and the interplay between mindfulness, self-efficacy, and other psychosocial variables to further inform patient-centered hemodialysis care.

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Key information

Conditions

Hemodialysis Behavior Chronic Disease Chronic Kidney Disease Disease Attributes Female Urogenital Diseases Female Urogenital Diseases and Pregnancy Complications Health Behavior Kidney Diseases Male Urogenital Diseases Pathologic Processes Pathological Conditions, Signs and Symptoms Personal Satisfaction Psychological Well-Being Renal Insufficiency Renal Insufficiency, Chronic Treatment Adherence and Compliance Urogenital Diseases Urologic Diseases

Age range

18 year and older

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

Primary location

Baskent University

Ankara, Turkey (Türkiye)

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

Voluntarily agreed to participate in the study

Receiving hemodialysis treatment for more than six months

Literate

18 years of age or older

Exclusion criteria

Diagnosed severe psychiatric disorder according to DSM-5 criteria

Auditory, visual, or cognitive impairments that could hinder participation in the educational process

Withdrawal Criteria:

Deterioration in general health status

Participant's request to discontinue participation

Treatment and study plan

The intervention group received mindfulness-based nursing interventions for six weeks

Other

The intervention group will receive mindfulness-based nursing interventions for 6 weeks, with one session per week averaging 1 hour.

Other names: mindfulness

Primary outcomes

Mindful Attention Awareness Scale (MAAS)

Time frame: 6 weeks from baseline

15-item scale scored on a 6-point Likert scale. Scores range from 15 to 90; higher scores indicate higher mindfulness.
Psychological Well-Being Scale (PWBS)

Time frame: 6 weeks from baseline

8-item scale scored on a 7-point Likert scale. Total scores range from 8 to 56; higher scores indicate higher psychological well-being.
End-Stage Renal Disease Adherence Questionnaire (ESRD-AQ)

Time frame: 6 weeks from baseline

9-item questionnaire assessing hemodialysis participation, medication adherence, fluid adherence, and diet adherence. Total scores range from 0 to 1200; higher scores indicate better adherence.

Sponsors and collaborators

Lead sponsor

Baskent University

Other

Registry information

Acronym: Mindfulness

Important dates

Study start: 2025
Primary completion: 2026
Study completion: 2026
First posted: Mar 13, 2026
Registry last updated: Mar 13, 2026

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

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This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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