Achieving consensus on psychosocial and physical rehabilitation management for people living with kidney disease

被引：10

作者：

Coyne, Emma ^{[1
]}

Briggs, Juliet ^{[2
]}

Loud, Fiona ^{[3
]}

Bristow, Paul ^{[3
]}

Young, Hannah M. L. ^{[4
]}

Castle, Ellen M. ^{[5
]}

Lightfoot, Courtney J. ^{[6
]}

Graham-Brown, Matthew ^{[7
]}

Eyre, Margaret ^{[8
]}

Ormandy, Paula ^{[9
]}

Sachar, Amrit ^{[10
]}

Bevin, Amanda ^{[11
]}

Burton, James O. ^{[7
]}

Wilkinson, Thomas J. ^{[4
,12
]}

Koufaki, Pelagia ^{[13
]}

Macdonald, Jamie ^{[14
]}

Ashman, Neil ^{[15
]}

Greenwood, Sharlene A. ^{[2
,16
]}

机构：

[1] Nottingham Univ Hosp NHS Trust, Nottingham, England

[2] Kings Coll Hosp NHS Trust, Renal Therapies, London, England

[3] Kidney Care UK, Alton, Hamps, England

[4] Leicester Gen Hosp, Leicester Diabet Ctr, Leicester, England

[5] Brunel Univ, Coll Hlth Med & Life Sci, Physiotherapy Div, London, England

[6] Univ Leicester, Dept Populat Hlth Sci, Leicester Kidney Lifestyle Team, Leicester, England

[7] Univ Leicester, Dept Cardiovasc Sci, Leicester, England

[8] York & Scarborough Teaching Hosp NHS Trust, York, England

[9] Univ Salford, Manchester, England

[10] Imperial Coll Healthcare NHS Trust & West London N, London, England

[11] Kent & Canterbury Hosp, London, England

[12] Leicester Biomed Res Ctr BRC, Natl Inst Hlth Res NIHR, Leicester, England

[13] Queen Margaret Univ, Edinburgh, Scotland

[14] Bangor Univ, Inst Appl Human Physiol, Bangor, Gwynedd, Wales

[15] Royal London Hosp NHS Trust, London, England

[16] Kings Coll London, Fac Life Sci & Med, London, England

来源：

CLINICAL KIDNEY JOURNAL | 2023年 / 16卷 / 11期

关键词：

CKD; exercise; physical activity; psychosocial; rehabilitation; HOSPITALIZATION; ASSOCIATION; DEPRESSION; HEALTH;

D O I：

10.1093/ckj/sfad116

中图分类号：

R5 [内科学]; R69 [泌尿科学（泌尿生殖系疾病）];

学科分类号：

1002 ; 100201 ;

摘要：

Lay Summary This paper presents the process for achieving consensus for the psychosocial and physical rehabilitation management of people living with chronic kidney disease. A modified Delphi process was used to achieve consensus and make recommendations about the changes that can be made to renal care. Nine final recommendations will be used to guide and ensure that people living with chronic kidney disease can live well with their condition. Background People living with chronic kidney disease (CKD) need to be able to live well with their condition. The provision of psychosocial interventions (psychological, psychiatric and social care) and physical rehabilitation management is variable across England, as well as the rest of the UK. There is a need for clear recommendations for standards of psychosocial and physical rehabilitation care for people living with CKD, and guidance for the commissioning and measurement of these services. The National Health Service (NHS) England Renal Services Transformation Programme (RSTP) supported a programme of work and modified Delphi process to address the management of psychosocial and physical rehabilitation care as part of a larger body of work to formulate a comprehensive commissioning toolkit for renal care services across England. We sought to achieve expert consensus regarding the psychosocial and physical rehabilitation management of people living with CKD in England and the rest of the UK. Methods A Delphi consensus method was used to gather and refine expert opinions of senior members of the kidney multi-disciplinary team (MDT) and other key stakeholders in the UK. An agreement was sought on 16 statements reflecting aspects of psychosocial and physical rehabilitation management for people living with CKD. Results Twenty-six expert practitioners and other key stakeholders, including lived experience representatives, participated in the process. The consensus (>80% affirmative votes) amongst the respondents for all 16 statements was high. Nine recommendation statements were discussed and refined further to be included in the final iteration of the 'Systems' section of the NHS England RSTP commissioning toolkit. These priority recommendations reflect pragmatic solutions that can be implemented in renal care and include recommendations for a holistic wellbeing assessment for all people living with CKD who are approaching dialysis, or who are at listing for kidney transplantation, which includes the use of validated measurement tools to assess the need for further intervention in psychosocial and physical rehabilitation management. It is recommended that the scores from these measurement tools be included in the NHS England Renal Data Dashboard. There was also a recommendation for referral as appropriate to NHS Talking Therapies, psychology, counselling or psychotherapy, social work or liaison psychiatry for those with identified psychosocial needs. The use of digital resources was recommended to be used in addition to face-to-face care to provide physical rehabilitation, and all healthcare professionals should be educated to recognize psychosocial and physical rehabilitation needs and refer/sign-post people with CKD to appropriate services. Conclusion There was high consensus amongst senior members of the kidney MDT and other key stakeholders, including those with lived experience, in the UK on all aspects of the psychosocial and physical rehabilitation management of people living with CKD. The results of this process will be used by NHS England to inform the 'Systems' section of the commissioning toolkit and data dashboard and to inform the National Standards of Care for people living with CKD.

引用

页码：2185 / 2193

页数：9

共 23 条

[1] Clinical practice guideline exercise and lifestyle in chronic kidney disease [J].