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

  • Systematic Review
  • Published:
Journal of Nephrology Aims and scope Submit manuscript

Abstract

Background

End-stage kidney disease (ESKD) incidence has been increasing over time, contributing significantly to morbidity and mortality. However, there is limited data examining the psychosocial factors affecting people with ESKD and how the social worker fits 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 the social worker in nephrology care.

Method

The 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.

Results

Of 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 findings of the studies were summarised into three major themes—psychosocial 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 that people who received support from social workers had an improved quality of life, lower depression scores, and reduced hospitalisations and emergency room visits.

Conclusion

This review summarizes the multitude of physical and psychological stressors that patients with ESRD face, and highlights the positive role 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 social workers as part of a multidisciplinary nephrology care.

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Funding

The authors declare that they have no relevant financial interest.

Author information

Authors and Affiliations

  1. Sydney Nursing School, Faculty of Medicine and Health, University of Sydney, Sydney, Australia

    Micaella Sotera Hansen

  2. Health Research Institute, University of Canberra, Canberra, Australia

    Wubshet Tesfaye

  3. Blacktown Hospital Western Sydney Local Health District (WSLHD), Blacktown, Australia

    Beena Sewlal & Bharati Mehta

  4. Westmead and Blacktown Hospitals, Western Sydney, Local Health District (WSLHD), Blacktown, Australia

    Bharati Mehta

  5. Department of Renal Medicine, Nepean Hospital, Nepean and Blue Mountains Local Health District, Kingswood, Australia

    Kamal Sud

  6. Sydney Medical School, Faculty of Medicine and Health, University of Sydney, Sydney, Australia

    Kamal Sud

  7. Department of Renal Medicine, Blacktown Hospital, WSLHD, Blacktown, Australia

    Lukas Kairaitis, Surjit Tarafdar & Katrina Chau

  8. School of Medicine, Western Sydney University, Sydney, Australia

    Lukas Kairaitis, Surjit Tarafdar & Katrina Chau

  9. School of Healthcare, University of Leeds, Leeds, UK

    Syed Tabish Zaidi

  10. School of Pharmacy, University of Sydney, Sydney, Australia

    Ronald Lynel Castelino

  11. Pharmacy Department, Blacktown Hospital, WSLHD, Blacktown, Australia

    Ronald Lynel Castelino

Authors
  1. Micaella Sotera Hansen
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  2. Wubshet Tesfaye
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  3. Beena Sewlal
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  4. Bharati Mehta
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  5. Kamal Sud
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Correspondence to Wubshet Tesfaye.

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Appendix A: Appraisal of selected studies

Appendix A: Appraisal of selected studies

JBI critical appraisal checklist for analytical cross-sectional studies (Moola et al.) [24]

Criteria

  1. 1.

    Were the criteria for inclusion in the sample clearly defined?

  2. 2.

    Were the study subjects and the setting described in detail?

  3. 3.

    Was the exposure measured in a valid and reliable way?

  4. 4.

    Were objective, standard criteria used for measurement of the condition?

  5. 5.

    Were confounding factors identified?

  6. 6.

    Were strategies to deal with confounding factors stated?

  7. 7.

    Were the outcomes measured in a valid and reliable way?

  8. 8.

    Was appropriate statistical analysis used?

Authors, year

1

2

3

4

5

6

7

8

Overall

Alleyne et al. [30]

N

Y

N

Y

N

N

N

N

Low

Bale et al. [2]

Y

Y

Y

Y

N

N

Y

Y

Average

Doborf et al. [17]

Y

Y

Y

Y

N

N

Y

Y

Average

Frank et al. [25]

Y

Y

N

Y

N

N

Y

Y

Average

Karolich et al. [26]

Y

Y

N

Y

Y

N

Y

Y

Average

Raiz et al. [31]

N

N

N

Y

Y

N

N

N

Low

Raiz et al. [32]

N

N

N

Y

N

N

N

Y

Low

Tijerina et al. [27]

Y

Y

N

Y

N

N

Y

Y

Average

Tijerina et al. [28]

Y

Y

N

Y

N

N

Y

Y

Average

  1. N no, Y yes

JBI critical appraisal checklist for randomized controlled trials (Tufanaru et al.) [23]

Criteria

  1. 1.

    Was true randomization used for assignment of participants to treatment groups?

  2. 2.

    Was allocation to treatment groups concealed?

  3. 3.

    Were treatment groups similar at the baseline?

  4. 4.

    Were participants blind to treatment assignment?

  5. 5.

    Were those delivering treatment blind to treatment assignment?

  6. 6.

    Were outcomes assessors blind to treatment assignment?

  7. 7.

    Were treatment groups treated identically other than the intervention of interest?

  8. 8.

    Was follow up complete and if not, were differences between groups in terms of their follow up adequately described and analyzed?

  9. 9.

    Were participants analyzed in the groups to which they were randomized?

  10. 10.

    Were outcomes measured in the same way for treatment groups?

  11. 11.

    Were outcomes measured in a reliable way?

  12. 12.

    Was appropriate statistical analysis used?

  13. 13.

    Was the trial design appropriate, and any deviations from the standard RCT design (individual randomization, parallel groups) accounted for in the conduct and analysis of the trial?

Authors, year

1

2

3

4

5

6

7

8

9

10

11

12

13

Overall

Beder et al. [3]

N

U

Y

Y

N

N

Y

Y

Y

Y

N

Y

U

High

Beder et al. [15]

N

U

Y

U

N

N

Y

N

Y

Y

Y

Y

U

Average

  1. N no, U unclear, Y yes

JBI critical appraisal checklist for qualitative research (Lockwood et al.) [22]

Criteria

  1. 1.

    Is there congruity between the stated philosophical perspective and the research methodology?

  2. 2.

    Is there congruity between the research methodology and the research question or objectives?

  3. 3.

    Is there congruity between the research methodology and the methods used to collect data?

  4. 4.

    Is there congruity between the research methodology and the representation and analysis of data?

  5. 5.

    Is there congruity between the research methodology and the interpretation of results?

  6. 6.

    Is there a statement locating the researcher culturally or theoretically?

  7. 7.

    Is the influence of the researcher on the research, and vice- versa, addressed?

  8. 8.

    Are participants, and their voices, adequately represented?

  9. 9.

    Is the research ethical according to current criteria or, for recent studies, and is there evidence of ethical approval by an appropriate body?

  10. 10.

    Do the conclusions drawn in the research report flow from the analysis, or interpretation, of the data?

Authors, year

1

2

3

4

5

6

7

8

9

10

Overall

Giles et al. [29]

Y

Y

N

Y

Y

N

N

Y

Y

Y

High

Giles et al. [6]

Y

Y

N

Y

Y

N

N

Y

Y

Y

High

  1. N no, Y yes

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Hansen, M.S., Tesfaye, W., Sewlal, B. et al. Psychosocial factors affecting patients with end-stage kidney disease and the impact of the social worker. J Nephrol 35, 43–58 (2022). https://doi.org/10.1007/s40620-021-01098-8

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  • DOI: https://doi.org/10.1007/s40620-021-01098-8

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