School of Health and Society, University of Salford, Room L530, Allerton Building, Salford, M6 6PU, UK.
School of Health and Society, University of Salford, Room 2.78, Mary Seacole Building, Salford, M6 6PU, UK.
BMC Nephrol. 2019 Mar 21;20(1):100. doi: 10.1186/s12882-019-1287-0.
Emerging evidence of psychosocial problems in CKD patients has led to an acceptance that a focus on the emotional wellbeing of the patient should be included in the provision of comprehensive CKD care. It is unclear if an increased attention for psychosocial needs in guidelines and policy documents has led to a rise in psychosocial staffing levels or change in composition of staff since the last workforce mapping in 2002. This paper offers a critical analysis and in-depth discussion of findings and their implications, in addition to providing an international perspective and exposing gaps in current knowledge.
Data on psychosocial staffing levels was taken from a survey based on the Scottish Renal Association's (SRA) staffing survey that was sent to all units in England, Wales and Northern-Ireland in 2016. In addition, data from a psychosocial staffing survey designed by and distributed via psychosocial professional groups was used. This data was then completed with Freedom of Information (FOI) requests and collated to describe the current renal psychosocial workforce in all 84 UK renal units. This was compared to results from the last renal workforce mapping in 2002.
The results from this mapping show great variability in models of service provision, significant exceeding of benchmarks for staffing levels, and a change in staffing patterns over the past 15 years. Adult psychology services have increased in number, but provision remains low due to increased patient numbers, whereas adult social work and paediatric services have decreased.
A lack in the provision of renal psychosocial services has been identified, together with the absence of a general service provision model. These findings provide a valuable benchmark for units, a context from which to review and monitor provision alongside patient need. Along with recommendations, this paper forms a foundation for future research and workforce planning. Research into best practice models of service provision and the psychosocial needs of CKD patients lies at the heart of the answers to many identified questions.
慢性肾脏病 (CKD) 患者的心理社会问题日益突出,这使得人们认识到,在提供全面的 CKD 护理时,应当关注患者的情绪健康。自 2002 年最后一次劳动力资源调查以来,指南和政策文件中对心理社会需求的关注度增加是否导致心理社会工作人员配备水平提高或工作人员构成发生变化,目前尚不清楚。本文除了提供国际视角和揭示当前知识空白外,还对调查结果进行了批判性分析和深入讨论。
心理社会工作人员配备水平的数据来自于一项基于苏格兰肾脏协会 (SRA) 工作人员调查的调查,该调查于 2016 年发送给英格兰、威尔士和北爱尔兰的所有单位。此外,还使用了由心理社会专业团体设计并分发的心理社会工作人员配备调查的数据。然后通过信息自由 (FOI) 请求获取数据,并进行整理,以描述所有 84 个英国肾脏单位的当前肾脏心理社会工作人员队伍。这与 2002 年最后一次肾脏劳动力资源调查的结果进行了比较。
此次调查结果显示,服务提供模式差异较大,工作人员配备水平明显超过基准,而且过去 15 年来工作人员配备模式发生了变化。成人心理服务数量有所增加,但由于患者人数增加,服务仍然不足,而成人社会工作和儿科服务则有所减少。
确定了肾脏心理社会服务的提供不足,以及缺乏一般的服务提供模式。这些发现为各单位提供了有价值的基准,可以根据患者需求,结合这些发现对服务提供情况进行审查和监测。除了建议外,本文还为未来的研究和劳动力规划奠定了基础。服务提供最佳实践模式和 CKD 患者心理社会需求的研究是许多已确定问题答案的核心。