Publications by authors named "Laura Plantinga"
Rationale & Objective: Dialysis patient care technicians (PCTs) provide essential, frontline care for patients receiving in-center hemodialysis. We qualitatively explored perceptions of the PCT job role, responsibilities, and training among current PCTs, non-PCT dialysis staff, and patients receiving hemodialysis.
Study Design: Focus group study.
Objective: Recent research has explored frailty in systemic lupus erythematosus using multiple measures. We examined the agreement among frailty measures and the association of each with cross-sectional and longitudinal health outcomes.
Methods: We used data from the California Lupus Epidemiology Study to examine the following measures of frailty: Systemic Lupus International Collaborating Clinics (SLICC) Frailty Index (SLICC-FI), Short Physical Performance Battery (SPPB), and Fatigue, Resistance, Ambulation, Illness, and Loss of Weight (FRAIL) scale questionnaire.
Limitations in Activities of Daily Living Among Individuals With Systemic Lupus Erythematosus.
Arthritis Care Res (Hoboken)
October 2024
Article Synopsis
- The study aimed to evaluate how systemic lupus erythematosus (SLE) affects people's ability to perform daily activities independently, specifically instrumental and basic activities of daily living (IADLs and BADLs).
- The research involved 436 participants, primarily female and Black, with over half reporting difficulties in IADLs like housekeeping and shopping, and significant limitations in BADLs such as bathing and dressing.
- Results indicated that higher disease activity, along with factors like depression, stress, lower income, and older age, strongly correlated with limitations in daily activities, highlighting the need for strategies to improve quality of life for older individuals with SLE.
Rationale & Objective: Given the high burden of dementia in dialysis patients, the dialysis workforce needs to be prepared to provide high-quality, person-centered dementia care. We explored comfort with and knowledge of dementia among US dialysis care providers.
Study Design: Web-based survey.
Objective: Cognitive impairment is a common complaint in SLE, but approaches to measuring cognitive performance objectively vary. Leveraging data collected in a population-based cohort of individuals with validated SLE, we compared performance and potential impairment across multiple measures of cognition.
Methods: During a single study visit (October 2019-May 2022), times to complete the Trail Making Test B (TMTB; N=423) were recorded; potential impairment was defined as an age-corrected and education-corrected T-score <35 (>1.
Fluid Cognition Among Individuals With Systemic Lupus Erythematosus.
Arthritis Care Res (Hoboken)
August 2024
Objective: We sought to describe fluid cognition and its correlates among individuals with systemic lupus erythematosus (SLE).
Methods: Participants (n = 199) were recruited from a population-based cohort for a single study visit (October 2019 to May 2022). Fluid cognition was measured via the National Institutes of Health Toolbox Fluid Cognition Battery (including episodic memory, working memory, attention and inhibitory control, processing speed, and cognitive flexibility domains) and expressed as age-corrected standard scores (mean 100, SD 15).
Importance: Dialysis patient care technicians (PCTs) play a critical role in US in-center hemodialysis (HD) care, but little is known about the association of PCT staffing with patient outcomes at US HD facilities.
Objective: To estimate the associations of in-center HD patient outcomes with facility-level PCT staffing.
Design, Setting, And Participants: This was a retrospective cohort study, with data analysis performed from March 2023 to January 2024.
Rationale & Objective: Technicians caring for patients receiving dialysis play a critical, frontline role in the care of patients receiving dialysis in the United States. We sought to provide a comprehensive description and identify correlates of US in-center hemodialysis facility patient care technician staffing patterns.
Study Design: This was an ecological study.
Article Synopsis
- The ASCENT study aimed to improve kidney transplant waitlisting and reduce racial disparities by educating staff and patients across 655 US dialysis facilities about changes to the kidney allocation system.
- The study used the Reach, Effectiveness, Adoption, Implementation, and Maintenance Framework to evaluate how well the intervention components were adopted, revealing that 57% of facilities were categorized as high implementers.
- Results showed that high implementer facilities had better waitlisting outcomes for Black patients compared to low implementers, although challenges in uniformly sharing educational resources were identified, highlighting areas for future improvement.
Importance: Evidence of effectiveness of advance care planning (ACP) strategies for patients receiving dialysis and their families is needed.
Objectives: To test the effectiveness of an ACP intervention to prepare patients and their surrogates for end-of-life (EOL) decision-making and to improve surrogate bereavement outcomes.
Design, Setting, And Participants: This cluster randomized clinical trial, An Effectiveness-Implementation Trial of SPIRIT (Sharing Patients' Illness Representations to Increase Trust) in ESRD, was conducted from December 2017 to March 2023 and included 42 dialysis clinics in 5 US states (Georgia, New Mexico, North Carolina, Pennsylvania, and Virginia) randomized to provide intervention or usual care.
Objective: For the majority of patients with lupus nephritis-related end-stage kidney disease (LN-ESKD), kidney transplant is associated with better outcomes than dialysis. Access to kidney transplant requires an initial referral to a transplant center and medical evaluation prior to waitlisting. The study's objective was to examine access to these early steps in the kidney transplant process among patients with LN-ESKD.
View Article and Find Full Text PDFObjective: To report the burden and correlates of poor physical performance in a diverse cohort of individuals with systemic lupus erythematosus (SLE).
Methods: In this single-visit study of 446 individuals with SLE from a population-based metropolitan Atlanta cohort, we measured physical performance via the Short Physical Performance Battery (score range 0-12; intermediate-low [<10] vs high [≥10]). We also collected demographic, clinical, and psychosocial variables and examined the associations (adjusted odds ratios [aORs]) of intermediate-low versus high physical performance with these characteristics via multivariable logistic regression.
Objective: In a study of physical and cognitive functioning among predominantly Black individuals with systemic lupus erythematosus (SLE), we compared remotely administered physical and cognitive performance assessments to those collected in person.
Methods: A subset of participants who completed an in-person visit in our parent study from 2021 to 2022 (n = 30) were recruited to complete a second, remote visit within 28 days. Physical performance (measured by a modified Short Physical Performance Battery [SPPB]; range 0-12; subscale ranges 0-4; higher = better performance) and cognitive performance (episodic and working memory adjusted t-scores, measured using NIH Toolbox) were measured at both visits.
Introduction: Suboptimal dialysis care may be in part due to staff issues such as job dissatisfaction, burnout, work overload, high staff turnover, and inconsistent training. Here, we leveraged data collected in a recent national survey to provide an initial, comprehensive description of current work experiences of US dialysis care providers.
Methods: We conducted a cross-sectional survey of 1,240 active US dialysis clinic staff members (physicians, advanced practice providers, nurse managers/clinic coordinators, nurses, social workers, dietitians, and patient care technicians), who were recruited via emails to society membership lists.
While older adults account for a disproportionate amount of healthcare spending, they are often underrepresented in clinical research needed to guide clinical care. The purpose of this perspective is to make readers aware of new data on age at enrollment for participants included in National Institutes of Health (NIH)-funded clinical research. We highlight key findings of relevance to general internal medicine and suggest ways readers could support the inclusion of older adults in clinical research.
View Article and Find Full Text PDFRationale & Objective: High professional fulfillment and low burnout and staff turnover are necessary for a stable dialysis workforce. We explored professional fulfillment, burnout, and turnover intention among US dialysis patient care technicians (PCTs).
Study Design: Cross-sectional national survey.
Background: The US kidney allocation system (KAS) changed in 2014, but dialysis facility staff (including nephrologists, social workers, nurse managers, and facility administrators) had low awareness of how this policy change could affect their patients' access to transplant. We assessed the effectiveness of a multicomponent and multilevel educational and outreach intervention targeting US dialysis facilities with low waitlisting, with a goal of increasing waitlisting and reducing Black versus White racial disparities in waitlisting.
Methods: The Allocation System Changes for Equity in Kidney Transplantation (ASCENT) study was a cluster-randomized, pragmatic, multilevel, effectiveness-implementation trial including 655 US dialysis facilities with low waitlisting, randomized to receive either the ASCENT intervention (a performance feedback report, a webinar, and staff and patient educational videos) or an educational brochure.
Rationale & Objective: Suboptimal care coordination between dialysis facilities and hospitals is an important driver of 30-day hospital readmissions among patients receiving dialysis. We examined whether the introduction of web-based communications platform ("DialysisConnect") was associated with reduced hospital readmissions.
Study Design: Pilot pre-post study.