Unmet Supportive Care Needs in U.S. Dialysis Centers and Lack of Knowledge of Available Resources to Address Them

Culp, Stacey; Lupu, Dale; Arenella, Cheryl; Armistead, Nancy; Moss, Alvin H.

doi:10.1016/j.jpainsymman.2015.11.017

Cited by 42 publications

(51 citation statements)

References 20 publications

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“…Literature suggests that patients with ESRD have little access to hospice and palliative care service compared to those with cancer or chronic life-threatening illnesses, and healthcare staffs are also ill prepared for providing RSC (Berzoff, Swantkowski & Cohen, 2008; Culp et al, 2016). In a cross-sectional survey, Combs and colleagues reported that 95% of US nephrology trainees felt that it was moderately to very important to learn how to provide RSC; however, their knowledge in this field was insufficient to meet the requirements (Combs et al, 2015).…”

Section: Discussionmentioning

confidence: 99%

A nationwide survey of healthcare personnel’s attitude, knowledge, and interest toward renal supportive care in Taiwan

Tsai

Chao

Chang

et al. 2017

PeerJ

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BackgroundRenal supportive care (RSC) is an important option for elderly individuals reaching end-stage renal disease; however, the frequency of RSC practice is very low among Asian countries. We evaluated the attitude, the knowledge, and the preference for specific topics concerning RSC among participants who worked in different medical professions in Taiwan.MethodsA cross-sectional questionnaire-based survey was employed. Healthcare personnel (N = 598) who were involved in caring for end-stage renal disease patients at more than 40 facilities in Taiwan participated in this study. Participants were asked about their motivation for learning about RSC, the topics of RSC they were most and least interested in, their willingness to provide RSC, and to rate their knowledge and perceived importance of different topics.ResultsThe vast majority of respondents (81.9%) were self-motivated about RSC, among whom nephrologists (96.8%) and care facilitators (administrators/volunteers) (45%) exhibited the highest and the least motivation, respectively (p < 0.01). Overall, respondents indicated that they had adequate knowledge about the five pre-specified RSC topics between medical professions (p = 0.04). Medical professions and institutional size exerted significant influence on the willingness to provide RSC.ConclusionsOur results facilitate the understanding of the knowledge and attitude toward different RSC topics among varied medical professions, and can guide the design of RSC education content for healthcare personnel.

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Section: Discussionmentioning

confidence: 99%

A nationwide survey of healthcare personnel’s attitude, knowledge, and interest toward renal supportive care in Taiwan

Tsai

Chao

Chang

et al. 2017

PeerJ

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“…However, responding appropriately to assessments will require models of care that encourage enhanced communication and multidisciplinary assessments. Dialysis guidelines and standards of care must start addressing directly these outcomes and using these patient-centered assessments to both guide and evaluate the quality of care (67).…”

Section: Identifying Process Barriers That May Arise When Patient-cenmentioning

confidence: 99%

Supportive Care: Integration of Patient-Centered Kidney Care to Manage Symptoms and Geriatric Syndromes

Davison

Jassal

2016

CJASN

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Dialysis care is often associated with poor outcomes including low quality of life (QOL). To improve patient-reported outcomes, incorporation of the patient's needs and perspective into the medical care they receive is essential. This article provides a framework to help clinicians integrate symptom assessment and other measures such as QOL and frailty scores into a clinical approach to the contemporary supportive care of patients with advanced CKD. This approach involves () defining our understanding of kidney supportive care, patient-centered dialysis, and palliative dialysis; () understanding and recognizing common symptoms associated with advanced CKD; () discussing the concepts of physical function, frailty, and QOL and their role in CKD; and () identifying the structural and process barriers that may arise when patient-centered dialysis is being introduced into clinical practice.

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“…Although clinical practice guidelines on shared decision-making for dialysis initiation and withdrawal exist, how these guidelines are incorporated into practice is variable. 10,11 This is a practical guide that will help nephrology providers better incorporate advance care planning (ACP) into routine care for dialysis patients. We present a DOI: 10.1111/sdi.12667 framework for how to introduce early ACP as well as triggered ACP discussions for patients who are declining.…”

Section: Introductionmentioning

confidence: 99%

A practical guide for the care of patients with end‐stage renal disease near the end of life

Bansal

Schell

2018

Seminars in Dialysis

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Most patients who rely on dialysis for treatment of end-stage renal disease (ESRD) never receive a kidney transplant. Therefore, it is important for nephrology providers to feel comfortable discussing the role of dialysis near the end of life (EOL). Advance care planning (ACP) is an ongoing process of learning patient values and goals in an effort to outline preferences for current and future care. This review presents a framework for how to incorporate ACP in the care of dialysis patients throughout the kidney disease course and at the EOL. Early ACP is useful for all dialysis patients and should ideally begin in the absence of clinical setbacks. Check-in conversations can be used to continue longitudinal discussions with patients and identify opportunities for symptom management and support. Lastly, triggered ACP is useful to clarify care preferences for patients with worsening clinical status. Practical tools include prognostication models to identify patients at risk for decline; ACP documents to operationalize patient care preferences; and communication guidance for engaging in these important conversations. Interdisciplinary teams with expertise from social work, palliative care, and hospice can be helpful at various stages and are discussed here.

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Unmet Supportive Care Needs in U.S. Dialysis Centers and Lack of Knowledge of Available Resources to Address Them

Cited by 42 publications

References 20 publications

A nationwide survey of healthcare personnel’s attitude, knowledge, and interest toward renal supportive care in Taiwan

A nationwide survey of healthcare personnel’s attitude, knowledge, and interest toward renal supportive care in Taiwan

Supportive Care: Integration of Patient-Centered Kidney Care to Manage Symptoms and Geriatric Syndromes

A practical guide for the care of patients with end‐stage renal disease near the end of life

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