Current Issue: Volume 37, Summer 2013
Table of Contents
The Chronic Disease Self-Management Program:A Resource for Use with Older CKD Patients
Tiffany Washington, PhD, MSW, School of Social Work, University of Georgia, Athens, GA; Tandrea Hilliard, MPH, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC; Terrance McGill, MD, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC
This commentary will briefly highlight the importance of promoting chronic disease self-management among older adults who are disproportionately affected by chronic kidney disease (CKD) stage 5. Older adults represent the fastest-growing segment of the CKD stage 5 population. Undoubtedly, the rapidly aging population will present new challenges and demands for the CKD health care community. The Chronic Disease Self-Management Program (CDSMP) is one existing intervention that has been recognized as potentially having utility for use with the CKD population. In this paper, we highlight opportunities for expanding the CDSMP to the population of older adults undergoing hemodialysis. The CDSMP is a six-week, lay-led, evidence-based program that includes interactive activities, such as behavior-specific action plans to improve chronic disease self-management behaviors. The CDSMP covers a wide range of health-related topics, including dealing with emotional struggles, effective communication, exercise, and nutrition. Special considerations for effective implementation of the CDSMP in hemodialysis settings are emphasized.
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The Talking About Live Kidney Donation (TALK) Social Worker Intervention: Putting it into Practice
Nicole DePasquale, MSPH, Felicia Hill-Briggs, PhD, Linda Darrell, MSW, LCSW-C, Patti L. Ephraim, MPH, Brenda Falcone, BA, Cassie Shafer, BS, Lapricia Lewis-Boyer, BS, LPN, L. Ebony Boulware, MD, MPH, Johns Hopkins University, Baltimore, MD
Live kidney transplantation (LKT) is underutilized among patients with kidney disease. Social workers may be particularly effective in helping patients and their families overcome barriers to considering and/or pursuing LKT because of their expertise in helping families confront challenging social and medical issues. Nonetheless, social workers' facilitation of patients' consideration of LKT has not previously been reported. The team at Johns Hopkins University developed and tested the Talking about Live Kidney Donation (TALK) Social Worker Intervention to improve patients' informed consideration of LKT. We provide practical guidelines for the implementation of the TALK Social Worker Intervention in clinical practice.
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African-American Attitudes Toward Kidney Transplant: A Comparative Analysis
Bradley Manton, MSW, Renal Research Institute: Carolina Dialysis Carrboro, Carrboro, NC; Caroline Jennette Poulton, MSW, University of North Carolina Kidney Center, Chapel Hill, NC
Racial disparities in kidney transplantation continue to persist despite voluminous studies attempting to address this problem. We conducted 26 semi-structured, one-on-one interviews with African-American and Caucasian dialysis patients to analyze whether or not there is a difference in attitudes toward kidney transplantation and whether or not this contributes to these disparities. Pre-dialysis education strongly correlates with a person's willingness to get listed, while fear of surgery and care of the transplanted kidney, and interaction with peers who have gone through a failed kidney transplant, decrease the chances of getting listed. Subjects did not report racial bias in being referred or worked-up for transplant. African Americans were more likely to weigh the pros and cons of transplants while Caucasians were more likely to see dialysis as temporary and viewed transplant as the default treatment for their kidney failure. All dialysis patients, but especially African Americans, may benefit from transplant education tailored to address specific patient concerns.
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