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. 2019 Jan 24;1(1):13-20.
doi: 10.1016/j.xkme.2018.12.001. eCollection 2019 Jan-Feb.

Pilot Intervention Addressing Social Support and Functioning of Low Socioeconomic Status Older Adults With ESRD: The Seniors Optimizing Community Integration to Advance Better Living with ESRD (SOCIABLE) Study

Deidra C Crews  1   2   3   4 , Alice M Delaney  5 , Janiece L Walker Taylor  2 , Thomas K M Cudjoe  6 , Manka Nkimbeng  2 , Laken Roberts  2 , Jessica Savage  2 , Allyson Evelyn-Gustave  2 , Jill Roth  2 , Dingfen Han  1 , LaPricia Lewis Boyér  7 , Roland J Thorpe Jr  4   8 , David L Roth  4   6 , Laura N Gitlin  2   9 , Sarah L Szanton  2   4   8
Affiliations

Pilot Intervention Addressing Social Support and Functioning of Low Socioeconomic Status Older Adults With ESRD: The Seniors Optimizing Community Integration to Advance Better Living with ESRD (SOCIABLE) Study

Deidra C Crews et al. Kidney Med. .

Abstract

Rationale & objective: Older adults with end-stage kidney disease have increased morbidity, fatigue, and decreased physical function, which can inhibit self-care and social engagement. We pilot tested a home-based program to improve physical and social functioning of low socioeconomic status older adults treated with hemodialysis (HD).

Study design: Qualitative study and randomized waitlist control intervention.

Setting & participants: Older adult HD patients in Baltimore, MD.

Interventions: We identified functional needs and home environmental barriers to social engagement through focus groups; mapped findings onto aspects of an established program, which includes home visits with an occupational therapist, nurse, and handyman to provide ≤$1,300 worth of repairs, modifications, and devices; and piloted the program (Seniors Optimizing Community Integration to Advance Better Living with ESRD [SOCIABLE]) among 12 older adult HD patients. We delivered the services over 5 months in a staggered fashion.

Outcomes: Feasibility and acceptability of the intervention and change in disability scores.

Results: Focus group themes included fatigue, lack of social support, and desire to live independently. SOCIABLE pilot participants were recruited from 2 dialysis units and all were African American (50% men); mean age was 69 years. At baseline, the mean disability score for activities of daily living (ADLs) was 4.4 and for instrumental ADLs (IADLs) was 6.3 (both out of a possible 16). Among the 9 participants alive at follow-up, there was 100% intervention completion and outcomes assessment. All treated participants improved a mean score of 2.3 for ADL and 2.6 for IADL disability, and social support and social network scores improved by 4.8 and 4.6, respectively.

Limitations: Small sample size; all participants were African American.

Conclusions: A home-based intervention addressing physical and social functioning of low socioeconomic status older adults on HD therapy was feasible and acceptable.

Keywords: Disability; activities of daily living; dialysis; home environment; older adults; qualitative study; social engagement; socioeconomic status.

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References

    1. Saran R., Robinson B., Abbott K.C. US Renal Data System 2017 Annual Data Report: epidemiology of kidney disease in the United States. Am J Kidney Dis. 2018;71(3 suppl 1):S1–S672. - PMC - PubMed
    1. O'Sullivan D., McCarthy G. An exploration of the relationship between fatigue and physical functioning in patients with end stage renal disease receiving haemodialysis. J Clin Nurs. 2007;16(11C):276–284. - PubMed
    1. Kittiskulnam P., Sheshadri A., Johansen K.L. Consequences of CKD on functioning. Semin Nephrol. 2016;36(4):305–318. - PMC - PubMed
    1. World Health Organization . WHO; Geneva, Switzerland: 2001. International Classification of Functioning, Disability and Health: ICF.
    1. Kimmel P.L., Fwu C.W., Eggers P.W. Segregation, income disparities, and survival in hemodialysis patients. J Am Soc Nephrol. 2013;24(2):293–301. - PMC - PubMed

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