Date of Award

Spring 4-7-2026

Document Type

Scholarly Project

Degree Name

Doctor of Nursing Practice (DNP)

Department

Nursing

First Advisor

Dr. Jacobson PhD, RN

Second Advisor

Dr. Comstock, RN, APRN, AGACNP-BC

Third Advisor

Jennifer Groff ACNP-BC, CNN-NP

Abstract

Practice Problem: Patients undergoing hemodialysis for end-stage kidney disease (ESKD) experience high rates of untreated depressive symptoms, which negatively impact quality of life, treatment adherence, and therefore increased hospitalization and higher mortality rates.

PICOT: In adult patients receiving in-center hemodialysis (P), how does the implementation of a structured mindfulness meditation program (I), compared to usual care (C), affect depressive symptoms as measured by the Patient Health Questionnaire-9 (PHQ-9) (O) over an eight-week period (T)?

Evidence: Current literature demonstrates that depression is highly prevalent among individuals with ESKD and is associated with increased morbidity and decreased treatment adherence. Evidence supports mindfulness meditation as an effective, nonpharmacologic intervention to reduce psychological distress, stress, and rumination in patients with chronic illness (Hofmann & Gómez, 2017).

Intervention: An eight-week, evidence-based mindfulness meditation program was implemented during dialysis treatments. Guided sessions were delivered chairside to promote accessibility within the clinical setting.

Outcome: Post-intervention PHQ-9 scores demonstrated a reduction, although not consistent or statistically significant, in depressive symptom severity among participating patients, indicating clinically meaningful improvement despite the small sample size.

Conclusion: Implementation of a structured mindfulness meditation program during hemodialysis is a feasible and clinically significant intervention that may reduce depressive symptoms in patients with ESKD. Integrating mindfulness into routine dialysis care offers a sustainable, nonpharmacologic strategy to address an important gap in depression management within this vulnerable population.

Comments

Scholarly project submitted to the University of St. Augustine for Health Sciences in partial fulfillment of the requirements for the degree of Doctor of Nursing Practice

Creative Commons License

Creative Commons Attribution 4.0 License
This work is licensed under a Creative Commons Attribution 4.0 License.

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