Psychosocial factors affecting patients with end-stage kidney disease and the impact of the social worker

Abstract

BackgroundEnd-stage kidney disease (ESKD) incidence has been increasing over time, contributing signi cantly to morbidity and early mortality.However, there is limited data examining the psychosocial factors affecting people with ESKD and how the social worker ts within the multidisciplinary CKD care. This integrative systematic review aims to summarise the existing evidence on psychosocial determinants of outcomes in ESKD and the role of renal social worker. Method:Literature search was conducted using PubMed and MEDLINE targeting articles published from database inception until May 2021.This systematic review was performed in compliance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. The Joanna Briggs Institute tools were employed to assess the quality of included studies. ResultsOf the 397 citations, 13 studies applicable to 1465 patients met the inclusion criteria. The studies were of cross-sectional, experimental, and exploratory qualitative design in nature. The ndings of the studies were summarised into three major themespsychosocial factors, role of the renal social worker, and impact of the renal social worker. The studies demonstrated that concerns related to adjustment, death and dying, family and social functioning, and loss were common amongst participants of the included studies indicating the need for a social worker. Three studies explored the impact of social workers in ESKD, revealing people who receive support from social workers had an improved quality of life, lower depression scores, reduced hospitalisations, and emergency room visits. ConclusionThis review reports the multitude of physical and psychological stressors that patients with ESRD face, highlights the positive role renal social workers can play in improving the psychosocial stressors in this patient group and the need for large-scale randomised trials to understand the role of renal social workers as part of a multidisciplinary care.

The psychosocial needs of patients who have chronic kidney disease without kidney replacement therapy: a thematic synthesis of seven qualitative studies

“…The themes of ‘honouring the patient’s need for control’, ‘adjusting to change’ and ‘recognising fear of treatment and disease’ reflect the importance of providing psychosocial support to help alleviate the disease burden in patients who have CKD without KRT. These themes reflect Hansen and colleagues’ [ 4 ] findings in their review of psychosocial needs in patients who have kidney failure. Patients who have kidney failure reported feeling a loss of freedom, autonomy and power, similar to some participants in the included studies, who shared a lack of control over their illness and a sense of helplessness [ 20 , 21 , 23 , 25 , 26 ].…”

“…These recommendations echo practitioners’ and patients’ views on kidney failure [ 2 , 3 ]. A systematic review recently identified the psychosocial needs of patients who have kidney failure, the majority of whom were dialysed or had received a transplant, highlighting a range of areas patients may need support with [ 4 ]. Qualitative findings indicate that patients experience substantial emotional burden with their illness, a complicated relationship with their treatment, fear of discussing their emotional difficulties with staff [ 5 ] and struggling to adapt to the invisibility and intangibility of kidney disease [ 6 ].…”

“Losing Faith in My Body”: Body Image in Individuals Diagnosed with End-Stage Renal Disease as Reflected in Drawings and Narratives

“…Numerous psychosocial stressors affect patients with ESRD. These include effects of diseases and treatment, functional limitations, sexual dysfunction, dietary restrictions, time constraints, and fear of death [ 22 ]. These stressors contribute to the expected psychological comorbidities, including depression, the most common diagnosis, affecting 10–50% of dialysis patients [ 6 ].…”

“…Based on the above review, (1) ESRD is a disease that negatively affects the person’s psychological and physical well-being [ 6 , 8 , 22 ], (2) body image is associated with self-perception [ 24 , 25 , 26 ], and (3) self-figure drawing can be used to assess self-perception and well-being [ 32 ]. The main research question was how individuals who undergo chronic dialysis due to ESRD perceive their bodies before (retrospectively) and currently as reflected in drawings and narratives.…”

“Together We Stand”: A Pilot Study Exploring the Feasibility, Acceptability, and Preliminary Effects of a Family-Based Psychoeducational Intervention for Patients on Hemodialysis and Their Family Caregivers

“…Patients have also to deal with the psychosocial consequences of ESRD and HD treatments, such as psychosocial distress and reduced quality of life [7,8]. For instance, the rate of psychiatric conditions, such as depression, in patients with ESRD is considerably higher than in populations with other chronic conditions such as cancer and congestive heart failure [9].…”