Volume 19, 1999
Table of Contents
Errata
Please note that Martha Hanthorn, LCSW, should have been included as a member of the editorial board of the 1999 Journal of Nephrology Social Work. Her name was omitted in error, and JNSW regrets failing to acknowledge her significant contribution to editing the journal.
The Family Perspective of End-of-Life Care in End Stage Renal Disease: The Role of the Social Worker
Anne Woods, LICSW; Joan Berzoff, EdD, LICSW; Lewis M. Cohen, MD; Cheryl-Ann Cait, LICSW; Penny Pekow, PhD; Michael German, MD; and David Poppel, MD
Factors Contributing to Caregiver Meaning: The Case of Mothers of Children on Dialysis
David B. Nicholas, PhD
Working Toward Improved Outcomes: Nephrology Social Work Quality Indicators
Mary Beth Callahan, ACSW/LMSW-ACP; Marrianne Moncrief, LMSW; and Laura Woodrow, LMSW
"The Emerald City Complex:" Transitional Depression in Adjustment to Organ Transplant: A Review of the Literature and Implications for Transplant Social Work
Barbara J. Levine, MSW, LICSW
The Effectiveness of a Structured Education Program on the Completeness of Advance Directives Among Hemodialysis Patients
Camille M. Yuscak, CSW-R, ACSW
Employment Following Renal Transplantation: The Employer Perspective
Lisa Raiz, PhD, LISW
Common Psychological Factors in the Treatment of End Stage Renal Disease
Laurie S. Rosen, MSW
Foreword to "The National Kidney Foundation's RISE Program"
Wendy Funk Schrag, LMSW, CNSW Annual Meeting Program Chair
The National Kidney Foundation's RISE Program
Wayne Nix, Educational Consultant, National Kidney Foundation of Michigan
Book Review: Ethical Standards in Social Work: A Ccritical Review of the NASW Code of Ethics
Leanne Peace, MSW, LCSW
CNSW Abstracts for the National Kidney Foundation's 49th Annual Meeting
Abstracts From Original Articles
The Family Perspective of End-of-Life Care in End Stage Renal Disease: The Role of the Social Worker
Anne Woods, LICSW; Joan Berzoff, EdD, LICSW; Lewis M. Cohen, MD; Cheryl-Ann Cait, LICSW; Penny Pekow, PhD; Michael German, MD; and David Poppel, MD
Approximately 21% of patients with end stage renal disease (ESRD) die each year. This study sought to elicit the perspective of the family about care given at the end of the patient's life. Three aspects of final care were considered: the family's experience of the loved one's terminal course and death, the nephrology social worker's involvement during the dying process and the quality and consistency of palliative care. Six weeks after the patients' deaths, interviews were conducted with twenty-one families at five dialysis units in New England. Both qualitative and quantitative analyses of data were performed. The findings suggest a need to review and improve palliative care for the ESRD population. Specific recommendations are made about the role of the nephrology social worker during this crucial time.
Key Words: end of life, terminal care, end stage renal disease, family center care.
Factors Contributing to Caregiver Meaning: The Case of Mothers of Children on Dialysis
David B. Nicholas, PhD
Twenty-four mothers caring for their children with chronic renal failure on dialysis were interviewed about the meanings they held about caregiving. Three distinct meanings emerged: caregiving as "entrapping"; caregiving as "manageable"; and caregiving as "natural." Factors associated with these three diverse meanings were also identified: (1) mothers' hopes, goals and family legacies; (2) mothers' view of the dialyzed child; (3) mothers' perceptions of social support; and (4) socioeconomic status. The findings of this study call for pediatric health care assessments, interventions, resources and outcome measures that recognize and respond to mothers' unique meanings of caregiving.
Key Words: pediatrics, maternal care takers, children, diagnosis, dialysis, maternal stress.
Working Toward Improved Outcomes: Nephrology Social Work Quality Indicators
Mary Beth Callahan, ACSW/LMSW-ACP; Marrianne Moncrief, LMSW; and Laura Woodrow, LMSW
Continuous quality improvement is an important component in the delivery of psychosocial services. Nephrology social work involvement as part of the end stage renal disease team's review of overall service delivery provides a systems perspective as in the case of hemodialysis adequacy and rehabilitation. Examples of clinical indicators are provided in this article as a basis for review of various factors related to the care of ESRD patients.
Key Words: rehabilitation, hemodialysis, continuous quality improvement, end stage renal disease.
"The Emerald City Complex:" Transitional Depression in Adjustment to Organ Transplant: A Review of the Literature and Implications for Transplant Social Work
Barbara J. Levine, MSW, LICSW
The goal of receiving an organ transplant and the uncertainty and unpredictability of reaching it often overshadow the patient's need and ability to plan for the return to productive and meaningful life. This can give rise to disappointment, frustration and stress once transplant is achieved. The transition from illness to transplant sometimes results in depression, and recipients of organ transplants can find these feelings perplexing in the light of a successful surgical outcome. Organ transplantation is presented as a life transition, and the experience is described through the use of The Wizard of Oz story as a parable. Transition, as well as other non-physiological frameworks for understanding depression after organ transplant, are explored through a survey of the literature. Application to social work practice with organ transplant patients is discussed.
Key Words: Adjustment, coping, depression, end stage renal disease, kidney disease, kidney transplant, life-changes, loss, organ transplant, quality of life, renal disease, transition, transplant.
The Effectiveness of a Structured Education Program on the Completeness of Advance Directives Among Hemodialysis Patients
Camille M. Yuscak, CSW-R, ACSW
The Patient Self-Determination (PSDA) Act mandates the education of patients regarding the use of advance directives such as health care proxy, living will, and do not resuscitate orders. A focused education campaign was conducted in accordance with the PSDA and National Kidney Foundation guidelines to increase patient awareness and completion of advance directives. This article describes how this program was conducted in the outpatient dialysis unit of a metropolitan medical center and the ongoing effects of such a structured education program.
Key Words: health care proxy, living will, do not resuscitate orders
Employment Following Renal Transplantation: The Employer Perspective
Lisa Raiz, PhD, LISW
Employment following transplantation is one outcome that has not achieved the success of initial predictions. This study examined employer attitudes and practices regarding hiring individuals who have had a renal transplant. Job performance appears to be of primary concern to employers, particularly missing work and lower productivity. An increase in health insurance rates was also of great concern. Additionally, many respondents reported negative beliefs and uncertainty regarding the status and course of individuals post-transplant. A combined effort from the transplant recipient, employer and transplant center is needed to promote and support employment following renal transplantation.
Key Words: transplantation, employment, employer attitudes, rehabilitation.
Common Psychological Factors in the Treatment of End Stage Renal Disease
Laurie S. Rosen, MSW
How can we understand the trauma of a person with end stage renal disease (ESRD) and its impact on his or her life? Is there a relationship between the patient's thoughts and feelings about his or her illness, and their compliance or non-compliance with treatment? Social workers are uniquely qualified to help patients and their families with the psychological consequences of ESRD.
Key Words: compliance, social work, end stage renal disease, transplantation.