Kidney Week

Abstract: SA-OR040

Utilizing Symptom Targeted Intervention to Help Dialysis Patients Remain Vocationally Active

Session Information

• Non-Cardiovascular Outcomes in Hemodialysis
  November 04, 2017 | Location: Room 292, Morial Convention Center
  Abstract Time: 06:18 PM - 06:30 PM

Category: Dialysis

• 607 Dialysis: Epidemiology, Outcomes, Clinical Trials - Non-Cardiovascular

Authors

• Evans, Deborah S., DaVita, Inc, Denver, Colorado, United States

Deborah S. Evans, MS



Deborah Evans, MA, MSW, LCSW I have been a clinical social worker with DaVita Inc. for the past 21 years. I’ve spent the majority of my career providing direct services to both in-center and home dialysis patients. For over half of my career, I have participated in research and initiatives aimed at improving patient outcomes, patient experience of care and adjustment to dialysis. In particular, I’m interested in supportive counseling and education that helps to empower patients to engage fully in their lives. Recently, I’ve become a full-time manager helping to oversee training, support and project management for 1900+ social workers across the country.

• Dunn, Duane V., DaVita, Inc, Denver, Colorado, United States

Duane V. Dunn,

• Aebel-Groesch, Kathryn M., DaVita, Inc, Denver, Colorado, United States

Kathryn M. Aebel-Groesch,

• Gervens, Jay, DaVita, Inc, Denver, Colorado, United States

Jay Gervens,

• Benner, Deborah A., DaVita, Inc, Denver, Colorado, United States

Deborah A. Benner,

Background

Ongoing vocational activity among patients with end-stage renal disease receiving dialysis is associated with considerable benefits, including better financial/insurance status, higher quality of life, and greater likelihood of receiving a kidney transplant. In spite of these benefits, most dialysis patients are not vocationally active. Perceived barriers to vocational activity include lack of access to transportation, depression, and lack of motivation. Here, we tested the utility of social workers applying Symptom Targeted Intervention (STI) to mediate psychosocial challenges and support ongoing vocational activity among dialysis patients.

Methods

In this pilot study (2016-2017), 85 specifically trained social workers at a large US dialysis organization provided 6 or more STI counseling sessions, delivered over a period of ~10 weeks, to dialysis patients who were either vocationally active (employed, student/trainee, volunteer) or interested in becoming vocationally active. Following completion of STI, each patient was matched to a control subject (no STI) based on geographic area, vocational status, and dialysis vintage. Subjects were followed until the earliest of transplant, death, loss to follow-up, or 6 months post-enrollment.

Results

Of 246 patients who received STI in the pilot study, 210 were matched to eligible controls (15 were withheld from matching due to enrollment in additional intervention programs; appropriate controls could not be identified for the remainder). A larger proportion of pilot patients were vocationally active during follow-up as compared to controls.

Conclusion

Previous work has shown that STI benefits patients who display difficulty with adjustment to dialysis. Here, we demonstrate that proactive incorporation of STI by social workers may support ongoing vocational activity among patients on dialysis.

Funding

• Commercial Support – DaVita, Inc