Volume 18, 1998
Table of Contents
Still Coping After All These Years: A Study of Psychosocial Variables Which Affect Long-Term Survival
Jean Carosella, LCSW; Steven Bogatz, MBA, MSW; Susan C. Lukas, LCSW; Milagros Manlongat, LCSW; Diane Rhoades, LCSW; Jonni Sage, LCSW; Beverly Simpson, LCSW
The Use of Mediation to Manage Patient-Staff Conflict in the Dialysis Clinic
Stephanie Johnstone, LCSW; Victoria J. Seamon, RN, CNN; Donna Halshaw, MSW; Jina Molinari, RN; Kevin Longknife
(Reprinted with permission from Advances in Renal Replacement Therapy, 4(4), 359-371.)
Utilizing the Case-Management Skills of the Nephrology Social Worker in a Managed Care Environment
Maureen McKinley, MSW, LCSW, USHAWL; Mary Beth Callahan, ACSW, LMSW/ACP
(Portions of this article appeared in NRAA Journal, 18, 32-36.)
Withdrawal From Dialysis: A Review With an Emphasis on the Black Experience
John E. Leggat, Jr.; Richard D. Swartz; Frederick K. Port
(Reprinted with permission from Advances in Renal Replacement Therapy, 4(1), 22-29.)
The Spectrum of Adherence Among Hemodialysis Patients
Christine Barsa del Alcazar, LCSW, PhD
Nephrology Social Work Interventions and the Effect of Caseload Size on Patient Satisfaction and Rehabilitation Interventions
Mary Beth Callahan, ACSW/LMSW-ACP; Marianne Moncrief, LMSW; Judi Wittman, LMSW; Marie Maceda, LMSW
The Effects of Patient and Staff Psychological Orientations on Patient Adherence to Fluid Intake Recommendations: A Program Evaluation
Adell Lenart, MSSW, CCSW
(Presented at the National Kidney Foundation 47th Annual Meeting)
A Study of the Pre-Disposing Factors of Depression in In-Center Chronic Hemodialysis
Rachel M. Estrada, MSW; Marjorie E. Hunt, MSW, PhD, ACSW
Should Children Ever Donate Kidneys? View of U.S. Transplant Centers
Aaron Spital, MD
(Reprinted with permission from Transplantation, 64(2), 232-236.)
Depression Anxiety: A Cognitive Behavioral Therapy Group for Dialysis Patients - A Case Study of Two Seven-Week Sessions
Elizabeth Graham Kaniarz, ACSW
Point: Ethics of a Paired-Kidney-Exchange Program
Lainie Friedman Ross, MD, PhD; David T. Rubin, MD; Mark Siegler, MD; Michelle A. Josephson, MD; J. Richard Thistlethwaite, Jr., MD, PhD; E. Steve Woodle, MD
(Reprinted with permission from The New England Journal of Medicine, Volume 336, pages 1752-1755)
Counterpoint: Commentary on the Ethics of a Paired-Kidney-Exchange Program
Rondi Wightman, MSW, LCSW
Book Review: Social Work Practice in Health Care Settings, Second Edition
Steve Bogatz, MBA, MSW
48th Annual Meeting Abstracts
Abstracts From Original Articles
Still Coping After All These Years: A Study of Psychosocial Variables Which Affect Long-Term Survival
Jean Carosella, LCSW; Steven Bogatz, MBA, MSW; Susan C. Lukas, LCSW; Milagros Manlongat, LCSW; Diane Rhoades, LCSW; Jonni Sage, LCSW; Beverly Simpson, LCSW
The Connecticut Chapter of the Council of Nephrology Social Workers asked the question: Do specific coping patterns have a positive impact on the survival of long-term dialysis patients? In partnership with the ESRD Network of New England, a research study involving all dialysis units in the state was conducted comparing dialysis survivors of eight or more years to those patients receiving treatments six months or less. The KDQOL-SF was utilized to collect the data and analyze the differences between the two groups. Two statistically significant psychosocial variables— management of emotional stress and spirituality & #151;contribute to positive coping which may, in turn, impact survival.
Key Words: social work; KDQOL-SF; coping; long-term survivors.
Utilizing the Case-Management Skills of the Nephrology Social Worker in a Managed Care Environment
Maureen McKinley, MSW, LCSW, USHAWL; Mary Beth Callahan, ACSW, LMSW/ACP
The role of the case manager in dialysis and transplant settings is becoming increasingly important as patients present with multiple, complex needs and find the managed care environment difficult to negotiate on their own. The nephrology social worker has the training, knowledge and skills to best perform this function for a large number of patients. This article explores the core functions of the nephrology social work case manager.
Key Words: case management; role of the nephrology social worker; managed care; disease management.
The Spectrum of Adherence Among Hemodialysis Patients
Christine Barsa del Alcazar, LCSW, PhD
Past research has attempted to evaluate why some hemodialysis patients follow medical advice whereas others do not, often labeling the "noncomplier" as self-destructive. Instead, this study redefined compliance behavior as a "spectrum of adherence" to reflect a range of possible adherence levels among hemodialysis patients. In order to evaluate where the patients were on the continuum, the "Spectrum of Adherence Index (SAI)" was devised which measured behaviors and attitudes associated with chronic hemodialysis. One hundred eleven patients participated in the study. Comparisons to traditional biomedical methods for measuring compliance were performed. Sociodemographic variables were assessed to determine associations with the SAI.
Key Words: non-compliance; spectrum of adherence; dialysis; social work.
Nephrology Social Work Interventions and the Effect of Caseload Size on Patient Satisfaction and Rehabilitation Interventions
Mary Beth Callahan, ACSW/LMSW-ACP; Marianne Moncrief, LMSW; Judi Wittman, LMSW; Marie Maceda, LMSW
Satisfaction with care is an outcome measure that may receive greater focus within managed care settings. This study used patient satisfaction as an outcome measure and found it to be significantly higher when social work to patient ratios were lower. Additionally, implementation of rehabilitation interventions was significantly higher when the social worker to patient ratio was lower. High caseloads diminished the availability of social workers to provide interventions that identify and ameliorate problematic circumstances that can contribute to poor patient outcomes.
Key Words: patient satisfaction; rehabilitation; social work staffing.
The Effects of Patient and Staff Psychological Orientations on Patient Adherence to Fluid Intake Recommendations: A Program Evaluation
Adell Lenart, MSSW, CCSW
Non-adherence to treatment recommendations is responsible for a range of consequences for dialysis patients from decreased vitality, to lost workdays, increased hospitalizations and, sometimes, death. It also affects patient-caregiver dynamics and dialysis staff morale. These effects on interpersonal dynamics and individual psychological orientations can, in turn, influence patients' success vis-a-vis eventual attempts to change non-adherent behaviors. This article provides a discussion of an intervention designed to address the needs of patients struggling with adherence to recommendations (in this case interdialytic fluid weight gain), as well as the needs of staff caring for them. It reports results from a longitudinal study focusing on the effects that a new fluid management program had on: a) patient behaviors and b) both patient and staff psychological orientations toward themselves and, for staff, toward their work environment.
Key Words: noncompliance; non-adherence; staff morale; job satisfaction.
A Study of the Pre-Disposing Factors of Depression in In-Center Chronic Hemodialysis
Rachel M. Estrada, MSW; Marjorie E. Hunt, MSW, PhD, ACSW
This study examined the relationships between levels of education, work history and client-defined support and depressive symptomology experienced by chronic in-center hemodialysis patients. Data was gathered using a single, one-time distribution of a questionnaire which included the Beck Depression Inventory. One hundred seventeen patients who had been on hemodialysis for no less than six months participated in this voluntary study. Positive relationships were found between educational levels, work history and client-defined support and increased levels of depressive symptomology.
The findings of this study also indicated a statistically significant relationship between marital status, housing and amount of time spent on dialysis in relation to increased levels of depression experienced by this sample. Further study of coping styles, self esteem and interventions utilized with such a population would provide nephrology social workers with additional relevant information from which to develop treatment plans and better defined objectives to assist dialysis patients with various levels of depression.
Key Words: hemodialysis; depression; employment; support systems; education.
Depression Anxiety: A Cognitive Behavioral Therapy Group for Dialysis Patients - A Case Study of Two Seven-Week Sessions
Elizabeth Graham Kaniarz, ACSW
Two group sessions, using Dr. David Burns' Ten Days To Self Esteem program, were conducted at an urban Detroit hospital-based dialysis unit. The nephrology social worker used Dr. Burns' materials for a cognitive/behavioral therapy framework. The materials were adapted for dialysis with the addition of a dialysis-related education format added at the end of each session. The focus of this group was to provide the renal patient with tools to work through depressive mood states that frequently accompany chronic dialysis. The best means to address depression in hemodialysis patients who are resistant to psychiatric intervention is unclear. Group cognitive/behavioral therapy is one way the nephrology social worker can assist patients in their battle with depression.
Key Words: Burns; cognitive/behavioral; depression; dialysis; end stage renal disease; group; social work.