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Table 2 Key content summary of the patient education program

From: Improving management of needle distress during the journey to dialysis through psychological education and training—the INJECT study feasibility pilot protocol


Learning outcomes

1. Introduction to needle distress

− What is needle distress, the causes and how it can be experienced

- Basic concepts of CBT (cognitive, emotional and behavioural signs of distress)

- Ways people may cope with needle distress

- Link between distress and avoidance

− Self monitoring and why it is important

2. Relaxed breathing

- Rationale and evidence for relaxation

- Practical exercise—the skill of relaxed breathing as a way of managing distress or anxiety

− Tips for practising/using relaxation

3. Visual imagery

- The use of visual imagery for relaxation

- Guided visual imagery exercise

− Tips for practising/using visual imagery

4. Cognitive strategies

- How thoughts, beliefs and attitudes influence our experience of distress or anxiety

- Guided mindfulness of thoughts exercise

− Cognitive strategies for managing unhelpful thoughts

5. Managing difficult emotions

- Acceptance of distress and present moment awareness

- Practical exercise: guided mindfulness of emotions

- Helpful tips

− The use of virtual reality (VR) technology as a distraction (immersion into different environment)

6. Summary

- Review of key strategies

- Preparing for slip-ups/setbacks

− Further support