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King A, Tanumihardjo J, Ahn D, Zasadzinski L, Robinson E, Quinn M, Peek M, Saunders M. Assessing knowledge of end-stage kidney disease and treatment options in hospitalized African American patients undergoing hemodialysis. Chronic Illn 2024; 20:145-158. [PMID: 37106575 DOI: 10.1177/17423953231168803] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/29/2023]
Abstract
OBJECTIVE African Americans are more likely to develop end-stage kidney disease (ESKD) than whites and face multiple inequities regarding ESKD treatment, renal replacement therapy (RRT), and overall care. This study focused on determining gaps in participants' knowledge of their chronic kidney disease and barriers to RRT selection in an effort to identify how we can improve health care interventions and health outcomes among this population. METHODS African American participants undergoing hemodialysis were recruited from an ongoing research study of hospitalized patients at an urban Midwest academic medical center. Thirty-three patients were interviewed, and the transcribed interviews were entered into a software program. The qualitative data were coded using template analysis to analyze text and determine key themes. Medical records were used to obtain demographic and additional medical information. RESULTS Three major themes emerged from the analysis: patients have limited information on ESKD causes and treatments, patients did not feel they played an active role in selecting their initial dialysis unit, and interpersonal interactions with the dialysis staff play a large role in overall unit satisfaction. DISCUSSION Although more research is needed, this study provides information and suggestions to improve future interventions and care quality, specifically for this population.
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Affiliation(s)
- Akilah King
- Department of Medicine, University of Chicago Medicine, Chicago, IL, USA
| | - Jacob Tanumihardjo
- Department of Medicine, University of Chicago Medicine, Chicago, IL, USA
| | - Daniel Ahn
- Pritzker School of Medicine, University of Chicago, Chicago, IL, USA
| | | | - Eric Robinson
- Department of Medicine, University of Chicago Medicine, Chicago, IL, USA
| | - Michael Quinn
- Department of Medicine, University of Chicago Medicine, Chicago, IL, USA
| | - Monica Peek
- Department of Medicine, University of Chicago Medicine, Chicago, IL, USA
| | - Milda Saunders
- Department of Medicine, University of Chicago Medicine, Chicago, IL, USA
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Saunders M, Quinn M, Duivenbode R, Zasadzinski L, Padela AI. A Pilot Efficacy Trial to Educate Muslim Americans about the Islamic Bioethical Perspectives in End-of-Life Healthcare. J Immigr Minor Health 2024; 26:133-139. [PMID: 37665539 DOI: 10.1007/s10903-023-01541-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/19/2023] [Indexed: 09/05/2023]
Abstract
In the US, end-of-life health care (EOLHC) is often intensive and invasive, and at times may involve care that is inconsistent with patient values. US Muslims may not receive appropriate religious support, experience uncertainty around end-of-life decision-making, and under-utilize palliative and hospice care. As technological advancements and treatment options rise in EOLHC, Muslim American patients and their families need to understand more about the treatment options that are consistent with their beliefs. The objective of this study was to determine the efficacy of a pilot mosque-based educational workshop focused on increasing Muslim Americans' religious bioethics knowledge about end-of-life healthcare. Intervention sites were four mosques with racially and ethnically diverse members, two in the Chicago metropolitan area and two in the Washington, D.C. area. Eligible participants were self-reported Muslims, aged 18 years or older, who were proficient in English. The intervention included a pre and post-test survey and a workshop focused on the Islamic bioethical perspectives on EOLHC. Knowledge was measured with six true-false questions. Baseline and post-intervention scores were analyzed by McNemar's test and bivariate correlation. Overall, the analysis showed a significant improvement in post-intervention participant knowledge. There was increased knowledge of Islamic bioethical views on the moral status of seeking healthcare, brain death controversies, and religious perspectives on withholding or withdrawing life support near the end of life. Our pilot intervention successfully increased participant knowledge and underscores the need to improve the Muslim community's knowledge about the bioethical dimensions of EOLHC.
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Affiliation(s)
- Milda Saunders
- Section of General Internal Medicine, Department of Medicine, University of Chicago Medical Center, 5841 S. Maryland Ave., MC2007, Chicago, IL, 60637, USA.
| | - Michael Quinn
- Section of General Internal Medicine, Department of Medicine, University of Chicago Medical Center, 5841 S. Maryland Ave., MC2007, Chicago, IL, 60637, USA
| | - Rosie Duivenbode
- Department of Women and Children's Health, Uppsala University, Uppsala, Sweden
| | - Lindsay Zasadzinski
- Section of General Internal Medicine, Department of Medicine, University of Chicago Medical Center, 5841 S. Maryland Ave., MC2007, Chicago, IL, 60637, USA
| | - Aasim I Padela
- Department of Emergency Medicine, Medical College of Wisconsin, Milwaukee, WI, USA
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Campbell KH, Ahn DJ, Enger F, Zasadzinski L, Tanumihardjo J, Becker Y, Josephson M, Saunders MR. Utility of geriatric assessments in evaluation of older adults for kidney transplantation. Clin Transplant 2022; 36:e14813. [PMID: 36124434 PMCID: PMC10078529 DOI: 10.1111/ctr.14813] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Revised: 07/28/2022] [Accepted: 08/29/2022] [Indexed: 12/27/2022]
Abstract
BACKGROUND While kidney transplantation has favorable outcomes in patients aged 65 years and older, many are not referred for evaluation despite having no contraindications. We wanted to determine whether incorporating geriatrics and geriatric assessments (GA), as part of kidney transplant evaluation at the University of Chicago Medicine, would help identify suitable candidates and improve transplantation outcomes among older adults. METHODS Between 2012 and 2016, as part of their multi-disciplinary transplant evaluation, 171 patients underwent an initial GA with the study geriatrician, who rated them on a five-point scale from "poor" to "excellent," and presented their cases to multidisciplinary transplant review meetings. Patients were followed until June 1st, 2021. Predictor variables included geriatric recommendation, clinical characteristics, and demographics. Outcomes of interest were mortality, receipt of transplant, and waitlist placement. RESULTS Compared to patients rated "poor," "marginal," or "fair," we found that patients that the geriatrician recommended as "good" or "excellent" were more likely to be waitlisted and receive a transplant. Favorably rated patients were also less likely to be removed from the waitlist due to becoming medically unfit, meaning worsening medical morbidity, frailty, and cognitive status. CONCLUSION Including geriatricians to perform GAs as part of the transplant evaluation process can help identify suitable elderly candidates.
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Affiliation(s)
- Kellie H Campbell
- Geriatrics and Extended Care, Edward J. Hines, Jr. Veterans Affairs Hospital, Chicago, Illinois, USA
| | - Daniel J Ahn
- The University of Chicago Pritzker School of Medicine, Chicago, Illinois, USA
| | - Frances Enger
- Section of General Internal Medicine, Department of Medicine, University of Chicago Medical Center, Chicago, Illinois, USA
| | - Lindsay Zasadzinski
- Section of General Internal Medicine, Department of Medicine, University of Chicago Medical Center, Chicago, Illinois, USA
| | - Jacob Tanumihardjo
- Section of General Internal Medicine, Department of Medicine, University of Chicago Medical Center, Chicago, Illinois, USA
| | - Yolanda Becker
- Section of Transplant Surgery, Department of Surgery, University of Chicago Medical Center, Chicago, Illinois, USA
| | - Michelle Josephson
- Section of Nephrology, Department of Medicine, University of Chicago Medical Center, Chicago, Illinois, USA
| | - Milda R Saunders
- Section of General Internal Medicine, Department of Medicine, University of Chicago Medical Center, Chicago, Illinois, USA
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Newman AKR, Herbozo S, Russell A, Eisele H, Zasadzinski L, Hassan C, Sanchez-Johnsen L. Psychosocial interventions to reduce eating pathology in bariatric surgery patients: a systematic review. J Behav Med 2021; 44:421-436. [PMID: 33580454 DOI: 10.1007/s10865-021-00201-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2020] [Accepted: 01/06/2021] [Indexed: 02/07/2023]
Abstract
Bariatric surgery is the most effective treatment for severe obesity; however, a subset of patients experience suboptimal outcomes. Psychosocial interventions that address eating pathology may ameliorate negative consequences, although their efficacy has not been examined. Thus, a systematic review to evaluate the impact of psychosocial randomized controlled trials (RCTs) on eating pathology in adults pre and post-bariatric surgery was conducted. Six scientific databases were searched for psychosocial trials assessing eating pathology as an outcome. Ten RCTs representing seven distinct interventions were identified (i.e., four preoperative and six postoperative). Trials utilized cognitive-behavioral therapy, mindfulness-based approaches, acceptance-based treatment, motivational interviewing, and psychoeducational interventions. Findings provide initial support for reducing eating pathology pre and postoperatively in the short-term (i.e., 6 months); however, the small number of RCTs and heterogeneity among postoperative trials made it difficult to draw conclusions. Additional longitudinal studies are needed to determine the long-term impact of psychosocial interventions that address eating pathology in bariatric surgery patients endorsing significant eating pathology.
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Affiliation(s)
- Alison Kaylen-Reynard Newman
- Department of Psychiatry, University of Illinois at Chicago, Chicago, IL, USA. .,Department of Surgery, University of Illinois at Chicago, Chicago, IL, USA.
| | - Sylvia Herbozo
- Department of Psychiatry, University of Illinois at Chicago, Chicago, IL, USA.,Department of Surgery, University of Illinois at Chicago, Chicago, IL, USA
| | - Andrea Russell
- Department of Psychiatry and Behavioral Sciences, Northwestern University, Feinberg School of Medicine, Chicago, IL, USA
| | - Heather Eisele
- Department of Psychiatry, University of Illinois at Chicago, Chicago, IL, USA.,Department of Surgery, University of Illinois at Chicago, Chicago, IL, USA
| | - Lindsay Zasadzinski
- School of Public Health, University of Illinois at Chicago, Chicago, IL, USA
| | - Chandra Hassan
- Department of Surgery, University of Illinois at Chicago, Chicago, IL, USA
| | - Lisa Sanchez-Johnsen
- Department of Family Medicine, Rush University Medical Center, Chicago, IL, USA.,Department of Psychology, University of Illinois at Chicago, Chicago, IL, USA
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Rahman S, Zasadzinski L, Zhu L, Edirisinghe I, Burton-Freeman B. Assessing consumers' understanding of the term "Natural" on food labeling. J Food Sci 2020; 85:1891-1896. [PMID: 32449960 DOI: 10.1111/1750-3841.15128] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2019] [Revised: 03/03/2020] [Accepted: 03/11/2020] [Indexed: 12/18/2022]
Abstract
The objective of this study was to gain a better understanding of how consumers' interpret the term "natural" by assessing food choice based on labels describing attributes of a product associated with the term "natural"; to assess food intake of chosen food, and; to determine factors that influence food choice and intake. A randomized, single-visit pilot study was conducted where participants (n = 105) were presented with seven identical bowls of granola each bearing a different descriptive label. Participants were asked to choose and eat the granola (ad libitum) that coincided with what was closest to their view of "natural." Food choice, intake amount, demographics, self-health perception, label use, dietary restraint, and mindfulness were measured. "Organic" (31%), "Made with real grains" (17%), and "No preservatives" (15%) were the top three chosen labels. These choices related to concerns about environment and processing, personal health, and additives and preservatives, respectively (P = 0.049). Income level and age were significantly associated with choice (P = 0.003). Defining the term "natural" for use on food labels will require follow-up researchacrosseconomically diverse populations and age groups to understand expectations of food products bearing the term "natural."
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Affiliation(s)
- Sajida Rahman
- Department of Food Science and Nutrition, Center for Nutrition Research, Illinois Institute of Technology, Chicago, IL, 60616, USA
| | - Lindsay Zasadzinski
- Department of Food Science and Nutrition, Center for Nutrition Research, Illinois Institute of Technology, Chicago, IL, 60616, USA
| | - Lanjun Zhu
- Department of Food Science and Nutrition, Center for Nutrition Research, Illinois Institute of Technology, Chicago, IL, 60616, USA
| | - Indika Edirisinghe
- Department of Food Science and Nutrition, Center for Nutrition Research, Illinois Institute of Technology, Chicago, IL, 60616, USA
| | - Britt Burton-Freeman
- Department of Food Science and Nutrition, Center for Nutrition Research, Illinois Institute of Technology, Chicago, IL, 60616, USA
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