Date of Conferral
11-4-2025
Date of Award
November 2025
Degree
Ph.D.
School
Social Work
Advisor
Peter Meagher
Abstract
Black individuals with end-stage renal disease (ESRD) have an excessive risk of mortality and experience ongoing inequities in end-of-life (EOL) planning. This basic qualitative study, informed by Sulmasy's biopsychosocial-spiritual model, explored social workers' perspectives about approaches that consider the interplay of physical, psychological, social, and spiritual aspects for mitigating barriers to EOL planning among Black dialysis patients. Data were obtained from semi structured interviews with 10 licensed dialysis social workers in Virginia and Maryland. Thematic analysis with descriptive coding, reflexive journaling, and peer debriefing was employed to analyze qualitative data to ensure trustworthiness. Six themes were identified: (a) building trust and rapport, (b) normalizing and integrating EOL discussions, (c) addressing family and cultural influence, (d) overcoming structural and resource barriers, (e) leveraging interdisciplinary collaboration, and (f) adapting communication approaches to enhance EOL planning. These findings highlight the importance of culturally responsive, relationship-based strategies and the routine incorporation of EOL planning into standard care practices. Dialysis social workers and other healthcare professionals may improve equity in EOL care by developing practices that respect Black patients' values, reduce medical mistrust, and enhance quality of life. By applying these strategies, providers may contribute to policies and interventions that strengthen patient-centered care and expand culturally competent support for diverse populations facing ESRD.
Recommended Citation
Kestner, Annette Carol, "Dialysis Social Workers' Perceptions of Strategies to Address Biopsychosocial-Spiritual Barriers to End-of-Life Planning With Black Dialysis Patients" (2025). Walden Dissertations and Doctoral Studies. 18630.
https://scholarworks.waldenu.edu/dissertations/18630
