1/15/08 - Nephrology Nursing Journal News Briefs

Contact: Linda Alexander
856-256-2300, ext. 2411 • linda@ajj.com

Nephrology Nursing Journal News Briefs

For African-American Women on Hemodialysis, Social Support, Psychological Factors Contribute to Fatigue
African Americans account for approximately 32% of patients diagnosed with ESRD, more than any other racial group in America. While fatigue is a common side effect for ESRD patients, studies have not explored factors contributing to fatigue, especially among African American women with ESRD. In the November-December 2007 issue of Nephrology Nursing Journal, Amy G. Williams, MSN, RN, and co-authors explored physiologic (anemia, uremic malnutrition), psychological (mood disorders) and situational factors (social support) contributing to fatigue in this group in hopes of developing life-improving interventions.

The authors found a correlation between social support and uremic malnutrition; this lack of support can lead to noncompliance in dietary requirements, which in turn leads to fatigue. In addition, Williams and co-authors found correlations between anxiety, depression and fatigue. The authors recommend further research examining the effect of social support and psychological factors on fatigue. For nephrology nurses, understanding the causes of fatigue in African American Women on hemodialysis will help focus assessments and individualized care plans for this patient population. (Fatigue in African American Women on Hemodialysis; Amy G. Williams, MSN, RN; Patricia B. Crane, PhD, RN, FAHA; Daria Kring, MSN, RN, BC; Nephrology Nursing Journal; November-December 2007; www.annanurse.org/journal)

Nephrology Nurses Stepping in to Help Caregivers of Hemodialysis Recipients Alleviate Anxiety and Depression
African American women who are caregivers of family members with end stage renal disease (ESRD) often deal with depression, anxiety and other symptoms of these hemodialysis recipients. However, depressive and anxiety symptoms can also strike the caregiver, especially black women. These family caregivers could benefit from an intervention to reduce these symptoms, and nephrology nurses are in a unique position to be the first ones to step in and help caregivers deal with these symptoms, say Mona N. Wicks, PhD, RN, and co-authors in their article in the November-December 2007 issue of Nephrology Nursing Journal.

The authors suggest using INSIGHT therapy, a behavioral group therapy approach designed to prevent and reduce depression in women. The group aspect creates a sense of community and sharing, an approach that may be especially important for some black women. Wicks and co-authors have implemented a three-year study of INSIGHT therapy in a group of black women who are caregivers of chronic hemodialysis recipients. They hope to reduce or eliminate depressive symptoms in this group, which will ultimately benefit the individual and the family member they care for. (INSIGHT Potentially  Prevents and Treats Depressive and Anxiety Symptoms in Black Women Caring for Chronic Hemodialysis Recipients; Mona N. Wicks, PhD, RN, et al; Nephrology Nursing Journal; November-December 2007; www.annanurse.org/journal)

Nephrology Nurses Need Education on Dialysis Shared Decision Making Guideline
In 2000, the Renal Physicians Association (RPA) and the American Society of Nephrology (ASN) revised guidelines directing the care of dialysis patients; the guidelines presented a shared decision-making process for the appropriate initiation and withdrawal of dialysis between providers and patients. Nephrologists have acknowledged and accepted these guidelines as practice; however, it is unclear if clinical nephrology nurses and nephrology nurse practitioners are aware of and accept these guidelines. Christy Price Rabetoy, NP, and Bradley C. Bair, MS, MStat, surveyed nephrology nurses on this topic and share the results in their article in the November-December 2007 issue of Nephrology Nursing Journal.

In their article, Rabetoy and Bair acknowledge more education is needed for nurses regarding the availability and application of the guidelines for assisting with patient care and difficult ethical situations. Nephrologists do seek input from nurses when dealing with these types of clinical situations, say the authors, so if nephrology nurses are not familiar with the guidelines, they may have limited influence on patient outcomes, may not be able to fulfill their roles as patient advocates and may not be involved in patient decision making. The authors recommend nephrology nurses increase their awareness, knowledge, and comfort level with difficult, ethical patient care decisions. (Nephrology Nurses’ Perspectives on Difficult Ethical Issues and Practice Guideline for Shared Decision Making; Christy Price Rabetoy, NP; Bradley C. Bair, MS, MStat; Nephrology Nursing Journal; November-December 2007; www.annanurse.org/journal)

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Members of the media: Feel free to use these news briefs as filler in your publications. For more information, or if you would like to interview on of the authors, contact Linda Alexander at Linda@ajj.com or 856-256-2300, ext. 2411.

Nephrology Nursing Journal is a refereed clinical and scientific resource that provides current information on a wide variety of subjects to facilitate the practice of professional nephrology nursing. Its purpose is to disseminate information on the latest advances in research, practice, and education to nephrology nurses to positively influence the quality of care they provide. For more information, visit www.annanurse.org/journal.