Evaluating the Effectiveness of Social Work Interventions:
Applications with Pediatric Dialysis Patients
Christopher C. Wilson, Master of Social Work Student, Texas Christian University
Background
• End-stage renal disease (ESRD), a form of
chronic kidney disease (CKD), occurs
when the kidneys are unable to function
properly and is treated by dialysis 1,2
• Two types of dialysis: peritoneal dialysis
is conducted in the home environment by
family; hemodialysis is conducted in a
medical facility by medical staff
• Statistics (2012): 14.1 out of every one
million children in the United States were
diagnosed with ESRD and 7,522 American
children were receiving ESRD treatment 3
• Children with ESRD are susceptible to
having a lesser quality of life due to being
at a greater risk for academic, social,
psychological, behavioral, and
developmental problems 4,5,6,7
Discussion
Methods
• Initial Hypothesis: 75% of patients would
see improvement in quality of life based
on an increase of at least 5 points on final
scores in comparison with baseline scores
• Longitudinal panel study design
• Initial sample: 30 patients ages 7-18
• Participants randomly selected from an
official census of current patients
• Only 50% of patients met the outcome
• PedsQL 3.0 ESRD Module child self-reports
and parent proxy-reports were individually
scored and averaged
• It is important that these measurement
tools are properly scored and compared
on an annual basis to asses the quality of
life of pediatric patients
• Mean scores obtained were plotted and
examined in order to reveal the occurrence
of positive or negative changes in the
quality of life for participants
• Social work interventions should be
considered and implemented alongside
medical treatment to effectively address
the quality of life domains: physical,
social and psychological 4
• Changes in quality of life were determined
by an increase or decrease in overall
scores
• Further research is required to determine
factors attributing to higher/lower scores
from parents in comparison to their
children
• Quality of life is measured using
measurement tools such as the PedsQL
• Results from recent studies utilizing this
measure have varied in regards to
identifying the greatest struggle(s) for
children with ESRD 7,8,9
• However, these studies all acknowledged
that parents scored their children lower
than the child scored themselves and that
the presence of a chronic illness is a
threat to one’s quality of life 7,8,9
Purpose
• Examined the effectiveness of social work
interventions with pediatric dialysis
patients from the Nephrology and
Dialysis Clinic at Cook Children's Medical
Center in Fort Worth, Texas
Sample Characteristics
Results
• 26 participants excluded from study:
•Treatment duration: N = 17, 65.38%
•Incompatible measures: N = 5, 19.23%
•Missing measures: N = 4, 15.38%
• Mean child self-report scores increased by
5.68 points over the course of treatment
• 4 participants comprised the final sample:
•Peritoneal dialysis: n = 2, 50%
•Hemodialysis: n = 2, 50%
•Mean Age: 14 years
•Male: n = 1, 25%
•Female: n = 3, 75%
•White: n = 5, 100%
•Hispanic: n = 2, 50%
•Not Hispanic: n = 2, 50%
• Mean parent proxy-report scores increased
by 16.29 points over the course of
treatment
• Further research is needed to examine
how the two types of dialysis may impact
quality of life
Limitations
• Parents scored higher than their children
scored themselves
• Small sample size does not adequately
represent the study population
• Peritoneal dialysis patients had an
increase in scores in comparison with
hemodialysis patients whose scores
decreased
• Low internal validity due to no
comparison or control group
• Potential inability to generalize findings
References
• Available upon request
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