School of Health and Society, University of Salford, Salford, United Kingdom.
PLoS One. 2022 Sep 26;17(9):e0275007. doi: 10.1371/journal.pone.0275007. eCollection 2022.
Patients living with progressive chronic kidney disease may face a variety of ongoing physical, emotional, financial and/or social challenges along the disease pathway. In most UK renal units, psychosocial support has traditionally been provided by a renal social worker. However, in recent years, the numbers of renal social workers have been declining. The specialised role is poorly understood and there is no UK research about the profession. To inform future research and guide workforce planning, this study presents the first-ever exploration of the UK renal social worker role. It aimed to map the profession's activities and reasons for involvement in patient care, as well as providing an initial evaluation of that involvement on patient wellbeing.
This mixed-method study recruited adult renal social workers (n = 14), who completed diaries over a 4-month period, participated in a focus group, and provided secondary data (caseload data and audit files where available) to give insight into their role. The evaluation of social work involvement on patient wellbeing used a pre-post intervention design. It measured distress, anxiety and depression levels as captured by the Distress Thermometer and Emotional Thermometers. A total of 161 patients completed the pre-involvement questionnaire, and 87 (55%) returned the post-involvement questionnaire.
The renal social worker role is creative, broad and fluid, with variations in roles linked to differences in employment and funding arrangements, configurations of the wider multidisciplinary renal team, level of standardisation of psychosocial care, availability of community services, and staff-to-patient ratios. Renal social work is different from statutory social work, and renal social workers are generally able to offer continuous rather than episodic care and support patients that would not meet strict local authority eligibility criteria. The findings showed that this support leads to significantly reduced distress and anxiety.
患有进展性慢性肾病的患者在疾病进展过程中可能会面临各种持续的身体、情感、经济和/或社会挑战。在大多数英国肾脏单位中，社会心理支持传统上由肾脏社会工作者提供。然而，近年来，肾脏社会工作者的数量一直在减少。该专业角色尚未被充分理解，英国也没有关于该职业的研究。为了为未来的研究提供信息并指导劳动力规划，本研究首次探索了英国肾脏社会工作者的角色。它旨在绘制该专业的活动图，并探讨其参与患者护理的原因，同时初步评估其对患者福祉的影响。
这项混合方法研究招募了成年肾脏社会工作者（n=14），他们在 4 个月的时间内完成了日记，参加了焦点小组，并提供了二级数据（如病例数据和审计文件），以深入了解他们的角色。使用前后干预设计评估社会工作者对患者幸福感的参与情况。它通过使用痛苦温度计和情绪温度计来衡量痛苦、焦虑和抑郁水平。共有 161 名患者完成了参与前的问卷，其中 87 名（55%）返回了参与后的问卷。
肾脏社会工作者的角色具有创造性、广泛性和灵活性，角色的变化与就业和资金安排、更广泛的多学科肾脏团队的配置、社会心理护理的标准化程度、社区服务的可用性以及员工与患者的比例有关。肾脏社会工作与法定社会工作不同，肾脏社会工作者通常能够提供连续而不是间歇性的护理和支持，这些患者不符合严格的地方当局资格标准。研究结果表明，这种支持显著降低了痛苦和焦虑程度。
