Volume 30, Winter 2008
Table of Contents
End-of-Life Care: We Can Do Better
Karren King, MSW, LCSW, ACSW, Kansas City, MO; Wendy Funk Schrag, LMSW, ACSW, Fresenius Medical Care North America, Newton, KS
The Kidney End-of-Life Coalition provides resources for staff, patients and families to facilitate education about death and dying issues and enhance their awareness and understanding of their emotions around these areas. The Coalition has four areas of focus: hospice, advance care planning, cardiopulmonary resuscitation and physician education. More education and resources in each of these areas will assist dialysis facilities and their staff in improving their delivery of care when faced with end-of-life issues. The Coalition's Web site, www.kidneyeol.org, provides detailed information and a wealth of resources for each area.
ERRATUM
In "End-of-Life Care: We Can Do Better" (WINTER, 2008, vol. 30, p. 11), the following text should replace the last sentence in the first paragraph of column two: "A survey of approximately 400 staff from 12 Michigan dialysis facilities documented that staff could recall no discussion about advance directives having taken place with nearly 70% of their patients and 39% of the staff reported they had never discussed advance directives with any patient (Perry et al., 1996)."
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Home Hemodialysis and Quality of Life
Mary Lou Buss, LCSW, Dialysis Center of Lincoln, Lincoln, NE
Home hemodialysis (HH) has been gaining the attention of renal professionals and patients. Most published studies of HH have been limited in their "generalizability" by small samples and limited descriptive and outcome data. This article describes the HH patients at a moderately sized regional dialysis center and details a measurement of quality of life (QOL). Using the Medical Outcomes Survey short form (SF)-36, baseline scores were compared with 6-month follow-up scores (N =36). Statistically significant improvement was found in three of the SF-36 domains: role-physical (p = 0.031), vitality (p = 0.018) and social functioning (p = 0.025), as well as physical component summary scores (p = 0.047). There were small nonsignificant improvements in all other domains. The results demonstrate improved QOL for patients using HH. http://edocket.access.gpo.gov/2008/pdf/08-1102.pdf
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COMMENTARY:
Developing Cultural and Linguistic Competence in the Renal Field
Robin Siegal, MA, MSW, LCSW, Westside Dialysis Peritoneal Dialysis Unit; Adjunct Faculty, University of Southern California School of Social Work, Los Angeles, CA
Racial and ethnic disparities in health care have been well documented. This article emphasizes the importance of expanding our definitions of culture and including linguistic competency in the field of cultural competence. Social workers need increased training and self-awareness in cultural competency to increase their effectiveness in the renal field. In addition, dialysis settings require a commitment to improved health literacy. Further research is needed on the globalization of the health care workforce and its influence in health care delivery and staff relations. Lastly, renal consumers, health care teams, dialysis providers and government entities need to collaborate on cultural competency strategies and interventions for patients, staff and the community.
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CNSW Abstracts from the national kidney foundation
2009 SPRING CLINICAL MEETINGS
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CNSW Research Grants Program
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