#PAGE_PARAMS# #ADS_HEAD_SCRIPTS# #MICRODATA#

Distress in patients with end-stage renal disease: Staff perceptions of barriers to the identification of mild-moderate distress and the provision of emotional support


Autoři: Gill Combes aff001;  Sarah Damery aff001;  Kim Sein aff001;  Kerry Allen aff002;  Johann Nicholas aff003;  Jyoti Baharani aff004
Působiště autorů: Institute of Applied Health Research, University of Birmingham, Edgbaston, Birmingham, United Kingdom aff001;  Health Services Management Centre, University of Birmingham, Edgbaston, Birmingham, United Kingdom aff002;  New Cross Hospital, Royal Wolverhampton NHS Trust, Wolverhampton, United Kingdom aff003;  Birmingham Heartlands Hospital, University Hospitals Birmingham NHS Trust, Birmingham, United Kingdom aff004
Vyšlo v časopise: PLoS ONE 14(11)
Kategorie: Research Article
doi: https://doi.org/10.1371/journal.pone.0225269

Souhrn

Objectives

To explore staff perceptions of barriers to the identification of mild to moderate distress and the provision of emotional support in patients with end-stage renal disease.

Methods

Qualitative semi-structured interviews with staff in two hospitals (n = 31), with data analysed using a hybrid approach combining thematic analysis with aspects of grounded theory.

Results

Staff appeared very aware that many patients with end-stage renal disease experience distress, and most thought distressed patients should be helped as part of routine care. However, practice was variable and looking for and addressing distress was not embedded in care pathways. Interviews identified six themes: i) staff perceptions about how distress is manifested and what causes distress were variable; ii) staff perceptions of patients could lead to distress being overlooked because patients were thought to hide their distress whilst some groups were assumed to be more prone to distress than others; iii) role perceptions varied, with many staff believing it to be their role but not feeling comfortable with it, with doctors being particularly ambivalent; iv) fears held back some staff, who were concerned about what might happen when talking about distress, or who found the emotional load for themselves to be too high; v) staff felt they lacked skills, confidence and training, vi) capacity to respond may be limited, as staff perceive there to be insufficient time, with little or no specialist support services to refer patients to.

Conclusions

Staff perceived significant barriers in identifying and responding to patient distress. Barriers related to skills and knowledge could be addressed through training, with training ideally targeted at staff with positive attitudes, but who currently lack skills and confidence. Barriers related to role perceptions would be harder to address. The study is relevant internationally as part of improving long-term condition pathways.

Klíčová slova:

Emotions – Fear – Chronic kidney disease – Medical dialysis – Medical doctors – Mental health and psychiatry – Nurses – Patients


Zdroje

1. Gregory DM, Way CY, Hutchinson TA, Barrett BJ, Parfrey PS. Patients’ perceptions of their experiences with ESRD and hemodialysis treatment. Qual Health Res. 1998;8(6):764–783. doi: 10.1177/104973239800800604 10558346

2. Kimmel PL. Depression in patients with chronic renal disease: what we know and what we need to know. J Psychosom Res. 2002;53(4):951–956. doi: 10.1016/s0022-3999(02)00310-0 12377308

3. Kimmel PL, Peterson RA. Depression in end-stage renal disease patients treated with hemodialysis: tools, correlates, outcomes, and needs. Semin Dial. 2005;18(2):91–97. doi: 10.1111/j.1525-139X.2005.18209.x 15771651

4. Zalai D, Szeifert L, Novak M. Psychological distress and depression in patients with chronic kidney disease. Semin Dial, 2012;25(4):428–438. doi: 10.1111/j.1525-139X.2012.01100.x 22809005

5. Cukor D. Use of CBT to treat depression among patients on hemodialysis. Psychiatr Serv. 2007;58(5):711–712. doi: 10.1176/ps.2007.58.5.711 17463356

6. Chilcot J, Spencer BW, Maple H, Mamode N. Depression and kidney transplantation. Transplantation. 2014;97(7):717–721. doi: 10.1097/01.TP.0000438212.72960.ae 24342977

7. Zabora J, Brintzenhofeszoc K, Curbow B, Hooker C, Piantadosi S. The prevalence of psychological distress by cancer site. Psychooncology. 2001;10(1):19–28. doi: 10.1002/1099-1611(200101/02)10:1<19::aid-pon501>3.0.co;2-6 11180574

8. Anderson WG, Alexander SC, Rodriguez KL, Jeffreys AS, Olsen MK, Pollak KI et al. “What concerns me is…” Expression of emotion by advanced cancer patients during outpatient visits. Support Care Cancer. 2008;16(7):803–811. doi: 10.1007/s00520-007-0350-8 17960430

9. Fisher L, Skaff MM, Mullan JT, Arean P, Mohr D, Masharani U et al. Clinical depression versus distress among patients with type 2 diabetes: not just a question of semantics. Diabetes Care. 2007;30(3):542–548. doi: 10.2337/dc06-1614 17327318

10. Wagena EJ, Arrindell WA, Wouters EFM, van Shayck CP. Are patients with COPD psychologically distressed? Eur Resp J. 2005;26:242–248.

11. Cohen SD, Norris L, Acquaviva K, Peterson RA, Kimmel PL. Screening, diagnosis, and treatment of depression in patients with end-stage renal disease. Clin J Am Soc Nephrol. 2007;2(6):1332–1342. doi: 10.2215/CJN.03951106 17942763

12. Waraich P, Goldner EM, Somers JM, Hsu L. Prevalence and incidence studies of mood disorders: a systematic review of the literature. Can J Psychiatry. 2004;49(2):124–138. doi: 10.1177/070674370404900208 15065747

13. Bautovich A, Katz I, Smith M, Loo CK, Harvey SB. Depression and chronic kidney disease: a review for clinicians. Aust N Z J Psychiatry. 2014;48(6):530–541. doi: 10.1177/0004867414528589 24658294

14. Soni RK, Weisbord SD, Unruh ML. Health-related quality of life outcomes in chronic kidney disease. Curr Opin Nephrol Hypertens. 2010;19(2):153–159. doi: 10.1097/MNH.0b013e328335f939 20051850

15. Cukor D, Rosenthal DS, Jindal RM, Brown CD, Kimmel PL. Depression is an important contributor to low medication adherence in hemodialyzed patients and transplant recipients. Kidney Int. 2009;75(11):1223–1229. doi: 10.1038/ki.2009.51 19242502

16. Clark S, Farrington K, Chilcot J. Nonadherence in dialysis patients: prevalence, measurement, outcome, and psychological determinants. Semin Dial. 2014;27(1):42–49. doi: 10.1111/sdi.12159 24164416

17. Sensky T, Leger C, Gilmour S. Psychosocial and cognitive factors associated with adherence to dietary and fluid restriction regimens by people on chronic haemodialysis. Psychother Psychosom. 1996;65(1):36–42. doi: 10.1159/000289029 8838695

18. Chilcot J, Wellsted D, Da Silva-Gane M, Farrington K. Depression on dialysis. Nephron Clin Pract. 2008;108(4):256–264.

19. McDade-Montez EA, Christensen AJ, Cvengros JA, Lawton WJ. The role of depression symptoms in dialysis withdrawal. Health Psychol. 2006;25(2):198–204. doi: 10.1037/0278-6133.25.2.198 16569111

20. Weisbord SD, Fried LF, Mor MK, Resnick AL, Unruh ML, Palevsky PM et al. Renal provider recognition of symptoms in patients on maintenance hemodialysis. Clin J Am Soc Nephrol. 2007;2(5):960–967. doi: 10.2215/CJN.00990207 17702730

21. Palmer S, Vecchio M, Craig JC, Tonelli M, Johnson DW, Nicolucci A et al. Prevalence of depression in chronic kidney disease: systematic review and meta-analysis of observational studies. Kidney Int. 2013;84(1):179–191. doi: 10.1038/ki.2013.77 23486521

22. Hedayati SS, Bosworth HB, Briley LP, Sloane RJ, Pieper CF, Kimmel PL et al. Death or hospitalization of patients on chronic hemodialysis is associated with a physician-based diagnosis of depression. Kidney Int. 2008;74(7):930–936. doi: 10.1038/ki.2008.311 18580856

23. Department of Health. Long term conditions compendium of information. London: Department of Health; 2012.

24. Kidney Health Advisory Group. Kidney Health: Delivering Excellence. Kidney Health Advisory Group, London; 2013.

25. Department of Health. The National Service Framework for Renal Services. Part two: chronic kidney disease, acute renal failure and end of life care. London: Department of Health; 2005.

26. National Institute for Health and Care Excellence. GS5 Chronic Kidney Disease quality standard. London: NICE; 2011.

27. Department of Health. Closing the gap: priorities for essential change in mental health. London: Department of Health; 2014.

28. England NHS. Five year forward view. NHS England; 2014.

29. Taylor F, Hare J, Combes G. Exploring patients’ attitudes to different intervention approaches for supporting psychosocial needs. J Ren Care. 2016;42(4):212–222. doi: 10.1111/jorc.12182 27753287

30. Schell JO, Patel UD, Steinhauser KE, Ammarell N, Tulsky JA. Discussions of the kidney disease trajectory by elderly patients and nephrologists: a qualitative study. Am J Kidney Dis. 2012;59(4):495–503. doi: 10.1053/j.ajkd.2011.11.023 22221483

31. Bristowe K, Horsley HL, Shepherd K, Brown H, Carey I, Matthews B et al. Thinking ahead–the need for early Advance Care Planning for people on haemodialysis: A qualitative interview study. Palliat Med. 2015;29(5):443–450. doi: 10.1177/0269216314560209 25527527

32. National Comprehensive Cancer Network (NCCN). NCCN Clinical Practice Guidelines in Oncology: Distress Management. Version 3, NCCN; 1998.

33. Wells KB, Burnam MA, Rogers W, Hays R, Camp P. The course of depression in adult outpatients: results from the Medical Outcomes Study. Arch Gen Psychiatry. 1992;49(10):788–794. doi: 10.1001/archpsyc.1992.01820100032007 1417431

34. Bass EB, Jenckes MW, Fink NE, Cagney KA, Wu AW, Sadler JH et al. Use of focus groups to identify concerns about dialysis: Choice study. Med Decis Making. 1999;19(3):287–295. doi: 10.1177/0272989X9901900307 10424835

35. Butow PN, Brown RF, Cogar S, Tattersall MH, Dunn SM. Oncologists’ reactions to cancer patients’ verbal cues. Psychooncology. 2002;11(1):47–58. doi: 10.1002/pon.556 11835592

36. Del Piccolo L, Mazzi MA, Mascanzoni A, Lonardi M, De Felice M, Danzi OP et al. Factors related to the expression of emotions by early-stage breast cancer patients. Patient Educ Couns. 2019, https://doi.org/10.1016/j.pec.2019.04.002.

37. Vail L, Sandhu H, Fisher J, Cooke H, Dale J, Barnett M. Hospital consultants breaking bad news with simulated patients: an analysis of communication using the Roter Interaction Analysis System. Patient Educ Couns. 2011;83(2):185–194. doi: 10.1016/j.pec.2010.05.016 21459254

38. Hack TF, Ruether JD, Pickles T, Bultz BD, Chateau D, Degner LF. Behind closed doors II: Systematic analysis of prostate cancer patients’ primary treatment consultations with radiation oncologists and predictors of satisfaction with communication. Psychooncology. 2012;21(8):809–817. doi: 10.1002/pon.1984 21557385

39. Taylor F, Taylor C, Baharani J, Nicholas J, Combes G. Integrating emotional and psychological support into the end-stage renal disease pathway: a protocol for mixed methods research to identify patients’ lower-level support needs and how these can most effectively be addressed. BMC Nephrol. 2016;17:111. doi: 10.1186/s12882-016-0327-2 27484760

40. Beaglehole R, Epping-Jordan A, Patel V, Chopral M, Ebrahim S, Kidd M et al. A renaissance in primary health care. In: Improving the prevention and management of chronic disease in low-income and middle-income countries: a priority for primary health care. The Lancet. 2008; 372(9642):940–949.

41. United Kingdom Renal Registry 20th Annual Report 2017. Renal Registry, Bristol, UK.

42. Charmaz K and Belgrave L. Qualitative interviewing and grounded theory analysis. In: The SAGE Handbook of Interview Research: The Complexity of the Craft. edited by Gubrium Jaber F., James A. Holstein, Marvasti Amir B., McKinney Karyn D.. 2012 Sage Publications, California, USA.

43. Braun V, Clarke V. Using thematic analysis in psychology. Qual Res Psych. 2006;3(2):77–101.

44. Absolom K, Holch P, Pini S, Hill K. Liu A, Sharpe Met al. The detection and management of emotional distress in cancer patients: the views of health-care professionals. Psychooncology. 2011; 20(6):601–608. doi: 10.1002/pon.1916 21308857

45. Dilworth S, Higgins I, Parker V, Kelly B, Turner J. Patient and health professional’s perceived barriers to the delivery of psychosocial care to adults with cancer: a systematic review. Psychooncology. 2014;23(6):601–612. doi: 10.1002/pon.3474 24519814

46. Turner J, Mackenzie L, Kelly B, Clarke D, Yates P, Aranda S. Building psychosocial capacity through training of front-line health professionals to provide brief therapy: lessons learned from the PROMPT study. Support Care Cancer. 2018;26(4):1105–1112. doi: 10.1007/s00520-017-3929-8 29063389

47. Jenkins K, Alberry B, Daniel J, Dixie L, North V, Patterson L et al. Beyond communication: The development of a training program for hospital and hospice staff in the detection and management of psychological distress–preliminary results. Palliat Support Care. 2010;8(1):27–33. doi: 10.1017/S1478951509990678 20163757

48. Botti M, Endacott R, Watts R, Cairns J, Lewis K, Kenny A. Barriers in providing psychosocial support for patients with cancer. Cancer Nurs. 2006;29(4):309–316. doi: 10.1097/00002820-200607000-00010 16871099


Článek vyšel v časopise

PLOS One


2019 Číslo 11
Nejčtenější tento týden
Nejčtenější v tomto čísle
Kurzy

Zvyšte si kvalifikaci online z pohodlí domova

KOST
Koncepce osteologické péče pro gynekology a praktické lékaře
nový kurz
Autoři: MUDr. František Šenk

Sekvenční léčba schizofrenie
Autoři: MUDr. Jana Hořínková

Hypertenze a hypercholesterolémie – synergický efekt léčby
Autoři: prof. MUDr. Hana Rosolová, DrSc.

Svět praktické medicíny 5/2023 (znalostní test z časopisu)

Imunopatologie? … a co my s tím???
Autoři: doc. MUDr. Helena Lahoda Brodská, Ph.D.

Všechny kurzy
Kurzy Podcasty Doporučená témata Časopisy
Přihlášení
Zapomenuté heslo

Zadejte e-mailovou adresu, se kterou jste vytvářel(a) účet, budou Vám na ni zaslány informace k nastavení nového hesla.

Přihlášení

Nemáte účet?  Registrujte se

#ADS_BOTTOM_SCRIPTS#