Psychosocial Factors in End-Stage Kidney Disease Patients at a Tertiary Hospital in Australia

Abstract

Aim. This study seeks to review the psychosocial factors affecting patients with end-stage kidney disease (ESKD) from a tertiary hospital in Australia. Methods. We audited patients with ESKD, referred to social work services from January 2012 to December 2014. All patients underwent psychosocial assessments by one, full-time renal social worker. Patient demographics, cumulative social issues, and subsequent interventions were recorded directly into a database. Results. Of the 244 patients referred, the majority were >60 years (58.6%), male (60.7%), born in Australia (62.3%), on haemodialysis (51.6%), and reliant on government financial assistance (88%). Adjustment issues (41%), financial concerns (38.5%), domestic assistance (35.2%), and treatment nonadherence (21.3%) were the predominant reasons for social work consultation. Younger age, referral prior to start of dialysis, and unemployment were significant independent predictors of increased risk of adjustment issues (p = 0.004, <0.001, and =0.018, resp.). Independent risk factors for treatment nonadherence included age and financial and employment status (p = 0.041, 0.052, and 0.008, resp.). Conclusion. Psychosocial and demographic factors were associated with treatment nonadherence and adjustment difficulties. Additional social work support and counselling, in addition to financial assistance from government and nongovernment agencies, may help to improve adjustment to the diagnosis and treatment plans as patients approach ESKD.

Psychosocial factors in patients with kidney failure and role for social worker: A secondary data audit

“…Progressive worsening of kidney function and concurrent rises in comorbidity and uraemic symptoms, such as fatigue, muscle weakness, light‐headedness, peripheral numbness, nausea and blurred vision reduces one's capacity to perform physical and functional activities of daily living (Abdel‐Kader et al, 2009; Campbell et al, 2008; Furr, 1998; Jablonski, 2004). Correspondingly, need for assistance with transport and home support were the second and third most predominant psychosocial issues expressed by participants in Phase 1, congruent with a previous study (Bale et al, 2016) that reported up to a third of participants having transportation‐related concerns. The proportion of people reporting transport‐related problems in this study increased substantially from Phase 1 to Phase 2 of illness.…”

“…Nephrology social workers elicit their expertise in areas of instrumental, informational and emotional support to provide effective psychosocial assessment, crisis intervention, patient and family education, supportive counselling, and interdisciplinary care planning and collaboration (Bale et al, 2016; Beder, 2000, 2008; Callahan, 2007; Furr, 1998). The social worker is the patients' and families' advocate and support system, helping them to cope with, understand and adjust to the profound obstacles they are confronted with as a result of kidney failure (Bale et al, 2016; Callahan, 2007). The imperative role of the social worker is evident through their capacity to recognise and ameliorate the myriad of psychosocial factors people with kidney failure experience, that contribute to depression, hospitalisation and protracted health complications (Beder, 2000, 2008; Hansen et al, 2021).…”

The effect of an educational program on quality of life in patients undergoing hemodialysis in western Saudi Arabia

“…Health related QOL is a multidimensional concept that reflects the health of a patient on a physical and mental basis. Therefore, evaluating QOL in HD patients will help to assess the provided care and evaluate the efficacy of medical treatment 17. Multiple international studies have shown the negative impact of CKD on QOL in patients undergoing HD, which ultimately affects their lifestyle.…”

Examining patient distress and unmet need for support across UK renal units with varying models of psychosocial care delivery: a cross-sectional survey study

“… 10 In the USA and Australia, renal dedicated social workers appear to be the point person responsible for providing psychosocial care, although in both countries high case loads and exceeded benchmarks were reported. 11–13 US renal social workers are in a special position, since ESRD is the only disease for which Medicare’s Conditions for Coverage Mandate requires a masters-level trained social worker on every interdisciplinary team. 14 Generally, in the UK, while all members of staff within the renal unit have a role in providing general psychosocial support, the core specialist psychosocial professionals include a psychologist (clinical, counselling or health), a counsellor or a psychotherapist, and/or a social worker.…”