TY - JOUR
T1 - Pilot Intervention Addressing Social Support and Functioning of Low Socioeconomic Status Older Adults With ESRD
T2 - The Seniors Optimizing Community Integration to Advance Better Living with ESRD (SOCIABLE)Study
AU - Crews, Deidra C.
AU - Delaney, Alice M.
AU - Walker Taylor, Janiece L.
AU - Cudjoe, Thomas K.M.
AU - Nkimbeng, Manka
AU - Roberts, Laken
AU - Savage, Jessica
AU - Evelyn-Gustave, Allyson
AU - Roth, Jill
AU - Han, Dingfen
AU - Boyér, La Pricia Lewis
AU - Thorpe, Roland J.
AU - Roth, David L.
AU - Gitlin, Laura N.
AU - Szanton, Sarah L.
N1 - Funding Information:
This study was funded by grant P30AG048773 from the National Institute on Aging , National Institutes of Health (NIH), Bethesda, MD. Dr Crews was supported by grant K23DK097184 from the National Institute of Diabetes and Digestive and Kidney Diseases , NIH, Bethesda, MD. The funders of this study had no role in study design; collection, analysis, or interpretation of data; writing the report; or the decision to submit the report for publication.
Publisher Copyright:
© 2019 The Author(s)
PY - 2019/1/1
Y1 - 2019/1/1
N2 - 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.
AB - 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.
KW - Disability
KW - activities of daily living
KW - dialysis
KW - home environment
KW - older adults
KW - qualitative study
KW - social engagement
KW - socioeconomic status
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UR - http://www.scopus.com/inward/citedby.url?scp=85065245687&partnerID=8YFLogxK
U2 - 10.1016/j.xkme.2018.12.001
DO - 10.1016/j.xkme.2018.12.001
M3 - Article
C2 - 32734179
AN - SCOPUS:85065245687
SN - 2590-0595
VL - 1
SP - 13
EP - 20
JO - Kidney Medicine
JF - Kidney Medicine
IS - 1
ER -