Sydney Nursing School, Faculty of Medicine and Health, University of Sydney, Sydney, Australia.
Health Research Institute, University of Canberra, Canberra, Australia.
J Nephrol. 2022 Jan;35(1):43-58. doi: 10.1007/s40620-021-01098-8. Epub 2021 Jun 28.
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.
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.
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.
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.
终末期肾病（ESKD）的发病率随着时间的推移一直在增加，对发病率和死亡率有重大影响。然而，关于影响 ESKD 患者的社会心理因素以及社会工作者如何适应 CKD 多学科护理的资料有限。本综合系统评价旨在总结 ESKD 结局的社会心理决定因素以及社会工作者在肾脏病护理中的作用的现有证据。
使用 PubMed 和 MEDLINE 进行文献检索，目标是从数据库开始到 2021 年 5 月发表的文章。本系统评价符合系统评价和荟萃分析的首选报告项目（PRISMA）声明。采用 Joanna Briggs 研究所工具评估纳入研究的质量。
在 397 条引文中有 13 项研究适用于符合纳入标准的 1465 名患者。这些研究的性质是横断面、实验性和探索性定性设计。研究结果总结为三个主要主题——社会心理因素、肾脏社会工作者的角色以及肾脏社会工作者的影响。这些研究表明，纳入研究参与者中常见的是与调整、死亡和垂死、家庭和社会功能以及丧失相关的担忧，这表明需要社会工作者。有三项研究探讨了社会工作者在 ESKD 中的作用，发现接受社会工作者支持的人生活质量得到提高，抑郁评分降低，住院和急诊就诊次数减少。
本综述总结了 ESRD 患者面临的大量身体和心理压力源，并强调了社会工作者在改善该患者群体的社会心理压力源方面可以发挥的积极作用，以及需要开展大规模随机试验来了解社会工作者作为多学科肾脏病护理一部分的作用。
