番茄社区

AUSTIN, Texas -- Dialysis patients with depression should be screened for suicidal ideation, researchers recommended here.

According to findings of a 13-item electronic survey conducted by Brooke Chehoski, MSW, of the University of South Carolina, and colleagues, 71% of nephrology social workers responded they screen for suicidality or suicidal ideation in their dialysis patients.

The majority of this screening is typically prompted by positive depression screenings or when the patient raises the concern themselves.

Presented at the , the survey showed 66% of respondents reporting use of the PHQ-9 screening tool, while some 40% used informal questioning such as, "Do you have thoughts of harming yourself?", "Have you ever tried to hurt yourself?", or "How long have you had these thoughts?"

"We decided to do this study because research suggests that people on dialysis may be at a higher risk for suicide," senior study author Teri Browne, PhD, MSW, of the University of South Carolina College of Social Work, explained to 番茄社区. "Every dialysis center in the United States has a master's-level social worker on their interdisciplinary teams to help patients address psychosocial barriers to outcomes, so we wanted to see what dialysis social workers across the country were doing in terms of screening patients for suicide risk."

She added their group were "encouraged that the majority of social work respondents to our national survey were doing some type of screening of patients for suicide." Still, she said, "29% of respondents were not doing any screening, and we do need further research to explore why all social workers do not do such screenings."

Following recruitment from an email sent to the NKF's Council of Nephrology Social Workers, the majority of respondents reported practicing at an in-center hemodialysis practice (83%), while around a third reported experience in a home dialysis setting, and 13% practiced in a transplant setting.

When asked around how many patients the social workers felt were at risk for suicide, 61% of respondents said only 1%-10% of their patients were at risk. Some 13% indicated 11%-20% of their patients were at risk; very few gave a higher proportion. On the other hand, 13% said they believed none of their patients were at risk.

Although the estimations of dialysis patients at risk for suicide was relatively low overall, the group recommended these patients should be screened for depression due to the prevalence depression among patients with serious, chronic conditions.

"Encouragingly, CMS now requires all dialysis patients to be screened for depression, which is a major problem for many patients and can be a factor in suicide. Hopefully, dialysis providers expand on routine mental health assessments of all patients by nephrology MSWs and be sure to also watch out for an screen patients for self-harm," said Browne.

She added how "creating robust mental health approaches to helping dialysis patients cope with kidney disease and treatments can help improve patient outcomes and quality of life. Social workers are in place in every dialysis unit and can lead these efforts, in conjunction with the interdisciplinary nephrology teams."

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