A mixed-methods feasibility study of an arts-based intervention for patients receiving maintenance haemodialysis

Claire Carswell, Joanne Reid, Ian Walsh, William Johnston, Helen McAneney, Robert Mullan, Jenny B Lee, Hugh Nelson, Michael Matthews, Elizabeth Weatherup, Andrea Spencer, Jean Michelo, Anne Quail, Grainne Kielty, Alistair Mackenzie, Jenny Elliott, Nicola Arbuckle, Anna Wilson, Helen Noble, Claire Carswell, Joanne Reid, Ian Walsh, William Johnston, Helen McAneney, Robert Mullan, Jenny B Lee, Hugh Nelson, Michael Matthews, Elizabeth Weatherup, Andrea Spencer, Jean Michelo, Anne Quail, Grainne Kielty, Alistair Mackenzie, Jenny Elliott, Nicola Arbuckle, Anna Wilson, Helen Noble

Abstract

Background: Haemodialysis can negatively impact quality of life and mental health. Arts-based interventions used successfully in other settings to improve health and well-being, could help address the impact of haemodialysis. This study aimed to evaluate the feasibility and acceptability of conducting a randomised controlled trial (RCT) of an arts-based intervention for patients receiving haemodialysis.

Methods: A parallel convergent mixed-methods design was used, including a pilot cluster RCT and qualitative process evaluation. Phase 1 evaluated recruitment and retention rates through a pilot cluster RCT at a single haemodialysis unit in Northern Ireland. Participants included patients who received haemodialysis for ESKD, were over the age of 18 and had the capacity to consent. These participants were randomised to the intervention or control group according to their haemodialysis shift. The intervention involved six one-hour, one-to-one facilitated arts sessions during haemodialysis. Phase 2 explored intervention and trial acceptability through a qualitative process evaluation using semi-structured interviews based on the RE-AIM framework. Participants included 13 patients who participated in phase 1 of the study, including 9 participants from the experimental group and four participants from the control group, and nine healthcare professionals who were present on the unit during implementation.

Results: Out of 122 outpatient haemodialysis patients, 94 were assessed as eligible for participation. Twenty-four participants were randomised, meaning 80% of the target sample size was recruited and the attrition rate at 3 months was 12.5% (n = 3). Participants viewed the arts as more accessible and enjoyable than anticipated following implementation. All participants who started the intervention (n = 11) completed the full six sessions. Qualitative benefits of the intervention suggest improvements in mental well-being. Patient choice and facilitation were important factors for successful implementation.

Conclusion: An arts-based intervention for patients receiving haemodialysis is acceptable for both patients and healthcare professionals, and a definitive trial is feasible. The intervention may help improve mental-wellbeing in patients receiving haemodialysis, but this requires further investigation in a definitive trial.

Trial registration: The trial was prospectively registered on clinicaltrials.gov on 14/8/2018, registration number NCT03629496 .

Keywords: Arts in health; Arts-based intervention; Complex intervention; End-stage kidney disease; Feasibility study; Haemodialysis; Pilot study; Process evaluation; Randomised controlled trials.

Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
CONSORT flow diagram
Fig. 2
Fig. 2
Mean anxiety and depression scores for the intervention group over 3-month longitudinal follow-up
Fig. 3
Fig. 3
Mean KDQOL-SF 36 subscale scores f or the intervention group over 3-month longitudinal follow-up

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Source: PubMed

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