How a five-minute chat can make a big difference to dialysis patients

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."