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How a Five-Minute Chat Can Make a Big Difference to Dialysis Patients

MAYWOOD, Ill. -- The constant health education that dialysis patients receive can lead to boredom and noncompliance.

But a Loyola University Medical Center study has found that brief, casual chats can be a significant benefit to patients.

The technique is called "talking control support therapy.” As patients were undergoing dialysis, researchers stopped by for informal chats. A typical conversation began with small talk, before moving on to general conversation about healthy dialysis lifestyles. Unlike conventional dialysis education, no specific education goals were set.

After 12 weeks, 82 percent of the study patients met or exceeded their target blood work goals for albumin and phosphorus, compared with 65 percent before the talking control therapy. And there was a 12 percent increase in patient-satisfaction scores.

Results were presented at the National Kidney Foundation 2012 Spring Clinical Meetings.

"In as little as five minutes per week, we can deepen connections to patients in meaningful ways," said Judith Beto, PhD, RD, first author of the study.
The study included 50 of the 120 patients in Loyola's dialysis center. (One patient dropped out after transferring to another unit.) The talking control therapy was conducted by 26 health professionals, including 18 student volunteers.

The health professionals randomly approached patients for informal conversations that lasted five to 10 minutes per week with 31 patients and 20 to 30 minutes per week with 18 patients. A "Getting Better" cart, filled with items as varied as pillboxes, Dots candy and frozen peanut butter-and-jelly sandwiches, was used to initiate conversations.  (The health educators explained that the PB&J sandwiches make convenient snacks when patients need to take food with medication, while Dots are an alternative to water for increasing saliva.)

The health educators discussed tips such as: taking medications on time by programming ring reminders on a cell phone, preventing constipation by eating a handful of unsalted almonds and an apple a day and increasing physical activity by wearing a pedometer to record how many steps the patient takes in a day.

Among the patients who underwent the talking control therapy, 24 percent showed stabilization of lab values and 76 percent showed improvement.
Researchers concluded that talking control therapy "may be an effective, low-cost patient-support technique that can involve all members of the interdisciplinary team."

Other co-authors are Katherine Schury, BS; Mary Nicholas, RN, MSN, CNN, APN; Nora Moravcik, RD, LD; Bessie Baldovino, RN, BSN, CNN; and senior author Vinod Bansal, MD.

Loyola University Health System (LUHS) is a member of Trinity Health. Based in the western suburbs of Chicago, LUHS is a quaternary care system with a 61-acre main medical center campus, the 36-acre Gottlieb Memorial Hospital campus and more than 30 primary and specialty care facilities in Cook, Will and DuPage counties. The medical center campus is conveniently located in Maywood, 13 miles west of the Chicago Loop and 8 miles east of Oak Brook, Ill. The heart of the medical center campus is a 559-licensed-bed hospital that houses a Level 1 Trauma Center, a Burn Center and the Ronald McDonald® Children's Hospital of Loyola University Medical Center. Also on campus are the Cardinal Bernardin Cancer Center, Loyola Outpatient Center, Center for Heart & Vascular Medicine and Loyola Oral Health Center as well as the LUC Stritch School of Medicine, the LUC Marcella Niehoff School of Nursing and the Loyola Center for Fitness. Loyola's Gottlieb campus in Melrose Park includes the 255-licensed-bed community hospital, the Professional Office Building housing 150 private practice clinics, the Adult Day Care, the Gottlieb Center for Fitness, Loyola Center for Metabolic Surgery and Bariatric Care and the Loyola Cancer Care & Research at the Marjorie G. Weinberg Cancer Center at Melrose Park.

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Jim Ritter
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