Mastering Hemodialysis to Reverse Patterns of Missed and Shortened Treatments.

Abstract

Missed and shortened treatments have potentially grave health consequences for dialysis patients, placing them at higher risk for fluid overload and increased hospitalizations. Missed treatments further negatively impact dialysis center revenues. Mindful of the social worker’s dual ethical responsibility to patients and employing agencies, the investigators proposed a research study aimed at reversing patterns of missed and shortened treatments. Drawing on the pioneering work of Prochaska and DiClemente, a transtheoretical model of behavioral change was adapted for nephrology social work with treatment-resistant dialysis patients in a comparative study involving three treatment approaches. The findings suggest improved motivation for treatment adherence, fewer hospitalizations and a decrease in missed and shortened treatments for patients in the social work intervention group.