Abstract: FR-PO863
"The Psychosocial Power Team": A Multidisciplinary Approach to Mitigating Health Inequities for Pediatric Patients on Hemodialysis
Session Information
- Diversity and Equity in Kidney Health - II
November 04, 2022 | Location: Exhibit Hall, Orange County Convention Center‚ West Building
Abstract Time: 10:00 AM - 12:00 PM
Category: Diversity and Equity in Kidney Health
- 800 Diversity and Equity in Kidney Health
Authors
- Whaley, Kristin, Nationwide Children's Hospital, Columbus, Ohio, United States
- Hermetz, Megan Grace, Nationwide Children's Hospital, Columbus, Ohio, United States
- Vogt, Beth A., Nationwide Children's Hospital, Columbus, Ohio, United States
- Grisham, Abby, Nationwide Children's Hospital, Columbus, Ohio, United States
- Van Der Eems, Tara J., Nationwide Children's Hospital, Columbus, Ohio, United States
- Bignall, Orville Newton-Ray, Nationwide Children's Hospital, Columbus, Ohio, United States
- Dawson, Anne E., Nationwide Children's Hospital, Columbus, Ohio, United States
Background
Children with kidney failure from minoritized communities face structural inequities that preclude access to home dialysis and portend poor outcomes. In-center hemodialysis (HD) confers disadvantages, including missed school and exposure to traumatizing procedures ledaing to decreased quality of life (QoL). To improve QoL and mitigate inequities for children on HD, we developed a multidisciplinary collaboration called the “Psychosocial Power Team” (PSPT). This team - comprised of child life, therapeutic recreation, massage therapy, social work, music therapy, nutrition, education, psychology, and nursing - used a modified quality improvement framework to pilot research-based psychosocial interventions to support social development and mental health for children on HD.
Methods
The PSPT created patient-specific and unit-wide treatment goals and interventions to support patient coping and adjustment. We sought to measure the impact of our interventions (e.g., collaborative meetings, educational games, cross-unit camaraderie activities, milestone celebrations, and emotional supports) on psychosocial outcomes in 16 children treated with HD.
Results
The PSPT created an average of 11 psychosocial goals per patient, with patients meeting 70% of goals. Post-intervention, fewer patients required psychology follow-up for psychosocial concerns (from 80% to 15% of patients). Patients demonstrated improved QoL ratings, often exceeding the average QoL expectations for patients on dialysis (Figure). Physical health metrics (e.g. serum phosphorus) are being tracked at this time.
Conclusion
Pediatric patients with kidney failure are at risk for poor psychosocial outcomes, due in part to structural inequities related to HD versus home dialysis. Through intentional, multidisciplinary collaboration, the PSPT demonstrated improved psychosocial health metrics in our pediatric dialysis unit.
Demonstration of QoL improvement for 2 patients on HD after PSPT intervention.