Introduction: Hemodialysis is a stressful process and is associated with social-  psychosocial problems, so the present study seeks to evaluate the effectiveness of acceptance and commitment therapy before starting dialysis, with and without sport exercises combined with mindfulness during dialysis to assess the hope of these patients.
Materials  and  Methods: The research design was semi-experimental with a control group with a two-month follow-up. The statistical population included all hemodialysis patients under the auspices of Imam Zaman Hospital in Mashhad from July to December 2020. 60 people were selected by purposive sampling method based on inclusion criteria and randomly divided into three groups (First: Acceptance and commitment therapy before starting dialysis and Second: Acceptance and commitment with and without sport exercises combined with mindfulness during dialysis) and control. Also, after 2 months, was performed on the groups follow-up test. The research tool included a hope questionnaire. Data analysis was performed by repeated measures analysis of variance.
   Results: The results showed that both acceptance and commitment groups before dialysis (P <0.001) and acceptance and commitment group with and without sport exercises combined with mindfulness during dialysis (P <0.001) is effective in increased hope (P <0.05) on hemodialysis patients.
Conclusion: Treatment based on Acceptance and commitment alone as an effective intervention can be used in medical centers to increase the hope of hemodialysis patients.

Keywords: Acceptance and commitment therapy, Hemodialysis, Mindfulness, Hope, Sport exercise

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