The INJECT study - effect of a self-management intervention on needle fear in adults receiving haemodialysis.

This pilot is a patient self-management intervention (INJECT) designed to empower patients to self-manage needle distress and to evaluate the feasibility and acceptability of the INJECT intervention. The intervention is based on Cognitive Behavioural Therapy (CBT) principles and it consists of: 1. Psychologist review to assess participant’s suitability for the intervention Patients eligible for the study will have a consult with the psychologist (face to face, or via telehealth) who will perform brief psychological assessment, and administer several questionnaires to confirm suitability for the intervention. The psychologist will also provide an overview of the CBT self-management modules and inform patients that the research officer will invite them via email to participate in an online learning program, which they can access via smart phone, laptop, iPad etc. 2. Psychoeducation about needle distress and strategies patients can apply to manage this delivered via an online learning platform 'Open Learning'. Program contains of 6 modules that are completed in 6 weeks at a rate of 1 module/week or faster. Each module takes 10-15 minutes to complete. Modules will contain written text, images, short videos and short activities. Website analytics before and after surveys will be used to assess the feasibility and acceptability to the intervention. The educational material included in the intervention is designed for this study based on the Cognitive Behavioural principles. 3. Option to use virtual reality (VR) technology as distraction during dialysis The psychologist will also inform the patient of the option to use Virtual Reality (VR) technology (as distraction) at dialysis during cannulation and have the headset in the consult for the patient to trial. Should the patient wish to use this in addition to completing the CBT modules, the psychologist will inform the Research officer of this, who will then inform the Nurse Unit Manager/nurse champion of the study at the patient’s dialysis site to coordinate delivery of VR at their subsequent dialysis sessions. VR goggles will have short relaxation videos (river, beach, nature videos) downloaded to help patients either during the cannulation process (needle insertion) or longer depending on their preference. 4. Support by practitioner nurses who have completed INJECT Nurse Education program Nurse practitioners who have also completed the nurse education program on Central Adelaide Local Health Network Learning Central (entitled- INJECT Nurse Education Program) will be available to support patients. 5. Weekly contact by the research officer to discuss progress and address any concerns or issues The duration of the intervention is 6 weeks. The goal of the intervention is to empower patients in self managing needle distress and to have access to tools/resources that will support skill building and be available to them as needed for revision and reinforcement of learning.