Journal of nephrology · 2025
Holistic needs assessment for hospitalized patients with kidney disease: a prospective cross-sectional study.
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Chao Cynthia Hsin-Ya, Tam Ka-Wai, Su Chien-Ling, Chou Yun-Yun, Kuo Tzu-Tung, Kao Juliana Tze-Wah
Аннотация
BACKGROUND: Kidney disease is a chronic health burden that considerably impairs patients' quality of life, necessitating a systematic evaluation of their holistic needs. This study employed the Taiwanese version of the Sheffield Profile for Assessment and Referral for Care (SPARC-T) questionnaire to identify unmet needs among patients with kidney disease.
METHODS: In this prospective, cross-sectional study, the patients completed the SPARC-T questionnaire upon admission to the nephrology ward. Scores exceeding predefined thresholds in the psychological, depression, religious and spiritual, or social domains triggered referral to a psychiatry department, social works, or a discharge planning team. Demographic information and SPARC-T scores were analyzed using logistic regression.
RESULTS: A total of 490 patients completed the questionnaire between January 2023 and June 2024. Of these, 47 patients (9.59%) had scores exceeding the threshold in at least one SPARC-T domain. The most frequently reported concerns were depression (6.94%) and spiritual distress (5.51%). Multivariate logistic regression revealed that female patients (odds ratio = 2.21, 95% confidence interval: 1.09 to 4.47) and individuals from low-income groups (odds ratio = 5.56, 95% confidence interval: 1.48 to 20.95) were significantly more likely to report higher distress scores.
CONCLUSIONS: Many patients with kidney disease, particularly women and those belonging to low-income groups, experienced unmet needs that extended beyond physical symptoms. Routine use of the SPARC-T is recommended to support patient-centered care by addressing psychological, spiritual, and social concerns alongside clinical management.
METHODS: In this prospective, cross-sectional study, the patients completed the SPARC-T questionnaire upon admission to the nephrology ward. Scores exceeding predefined thresholds in the psychological, depression, religious and spiritual, or social domains triggered referral to a psychiatry department, social works, or a discharge planning team. Demographic information and SPARC-T scores were analyzed using logistic regression.
RESULTS: A total of 490 patients completed the questionnaire between January 2023 and June 2024. Of these, 47 patients (9.59%) had scores exceeding the threshold in at least one SPARC-T domain. The most frequently reported concerns were depression (6.94%) and spiritual distress (5.51%). Multivariate logistic regression revealed that female patients (odds ratio = 2.21, 95% confidence interval: 1.09 to 4.47) and individuals from low-income groups (odds ratio = 5.56, 95% confidence interval: 1.48 to 20.95) were significantly more likely to report higher distress scores.
CONCLUSIONS: Many patients with kidney disease, particularly women and those belonging to low-income groups, experienced unmet needs that extended beyond physical symptoms. Routine use of the SPARC-T is recommended to support patient-centered care by addressing psychological, spiritual, and social concerns alongside clinical management.