Environmental – Transportation – KidneyPal

Transportation

Environmental Domain

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ENVIRONMENTAL

In the Environmental Domain, the sociodemographics that were moderately correlated were marital status (V = .362) and occupational status (rpb = .321). These two factors had a stronger relationship to environmental quality of life (QoL) compared to the other variables, which showed only weak correlations.

Marital status affected the Environmental Domain because having a spouse often provided emotional, financial, and practical support—such as assistance with transportation to dialysis, navigating the healthcare system, and maintaining a safe, stable home environment. Married patients tended to have better access to resources that improve environmental QoL, while single, divorced, or widowed individuals sometimes struggled with these supports, impacting their living conditions and access to care. Occupational status also influenced the Environmental Domain significantly. Employed patients benefited from better financial stability, allowing them to afford safer housing, better transportation, and necessary healthcare services. On the other hand, unemployed patients often faced financial hardships, limiting their environmental supports and worsening their ability to maintain a healthy and stable living situation.

Thus, marital and employment statuses moderately affected how CKD patients experienced their environment, while other factors like age, sex, education, income, and comorbidities had only weak effects.

Transportation

It is a way to travel and provide access to healthcare, education, employment, food, and social activities (WHO, 2014). Operationally, it is the ease of getting to dialysis and healthcare facilities for hemodialysis patients.

General Interventions

(For age, sex, marital status, household income, comorbidities)

1. Plan transportation in advance for your dialysis appointments to reduce last-minute stress.

Proper planning ensures you arrive on time, reducing anxiety and stress. (Murdeshwar & Anjum, 2023).

2. Explore carpooling or ride-sharing services with fellow dialysis patients for convenience and companionship.

Sharing rides can reduce costs and foster social connections, promoting emotional well-being. (Murdeshwar & Anjum, 2023).

3. Use community transport services for dialysis patients or those with chronic illnesses to make travel more accessible.

Access to specialized transport options ensures reliable and safe travel for dialysis patients. (Murdeshwar & Anjum, 2023).

Marital Status-Based: Married

1. Coordinate with your spouse to arrange shared transportation to dialysis sessions to reduce both time and stress.

Shared transportation promotes partnership and reduces individual burden. (Lewis et al., 2022).

2. Establish a backup transportation plan (e.g., nearby relatives or public transit) in case your spouse is unavailable.

Having a backup plan ensures consistent and reliable access to transportation . (Lewis et al., 2022).

3. Consider family-based ride-sharing apps or services to minimize the financial strain of transportation.

Affordable transportation options make travel more accessible and reduce financial stress. (Lewis et al., 2022).

Marital Status-Based: Widowed

1. Utilize senior transport services designed for patients to ensure safe and comfortable travel to dialysis sessions.

Senior-specific transportation services cater to the unique needs of elderly patients. (Fresenius Medical Care Asia-Pacific Ltd., 2023.).

2. Seek assistance from family, friends, or neighbors to arrange transportation for you to reduce dependence on public transit.

Family and neighbor support reduces feelings of isolation and ensures safer travel. (Fresenius Medical Care Asia-Pacific Ltd., 2023.).

3. Join a local transport assistance program that specifically caters to people with chronic illnesses or elderly patients.

Specialized transport assistance ensures safe, reliable, and accessible travel. (Fresenius Medical Care Asia-Pacific Ltd., 2023.).

Marital Status-Based: Separated

1. Consider contacting support groups for transportation arrangements, especially if you’re adjusting to changes in daily routines.

Support groups can offer shared transportation, reducing isolation and stress. (Lewis et al., 2022).

2. Check for local charity transportation programs that offer free or low-cost rides to dialysis appointments.

Charitable transport services ensure accessibility and reduce financial strain. (Lewis et al., 2022).

3. Use neighborhood ride-sharing options or community carpooling to ensure reliable access to transportation.

Community-based carpooling provides flexible and low-cost options (Lewis et al., 2022).

Marital Status-Based: Single

1. Take advantage of public transport passes or discounts for chronic illness patients to reduce commuting costs.

Public transportation discounts alleviate financial burdens. (Lewis et al., 2022).

2. Use ride-sharing services with medical assistance options for a more comfortable and stress-free travel experience.

Ride-sharing services designed for patients ensure safe, comfortable transport. (Lewis et al., 2022).

3. Partner with local dialysis patients or support groups to share rides, reducing travel costs and providing social support.

Shared rides improve community bonding and reduce isolation. (Lewis et al., 2022).

Occupational Status-Based: Unemployed

1. Explore local transportation options that offer discounts for chronic illness patients or those with low income.

Discounted transport options ease financial strain and ensure reliable access to medical care. (Guo et al., 2021).

2. Organize rides with fellow unemployed patients or community members to share costs and reduce isolation.

Community ride-sharing fosters support and reduces transportation costs. (Guo et al., 2021).

3. Research for free or low-cost local shuttle services specifically available for medical appointments.

Free transport services provide economic relief and ensure access to essential healthcare (Guo et al., 2021).

Occupational Status-Based: Employed

1. Plan your commute to dialysis in advance, considering the impact of your work schedule and treatment timings.

Planning ahead ensures timely arrival and reduces the stress of overlapping work and dialysis commitments. (Guo et al., 2021).

2. If possible, arrange for flexible working hours or telecommuting on dialysis days to reduce stress related to commuting.

Flexible work arrangements reduce travel-related stress and improve well-being. (Guo et al., 2021).

3. Look into employer-provided transportation services or allowances for medical appointments, including dialysis.

Employer-provided transport options support employee health and well-being. (Guo et al., 2021).

References

Murdeshwar, H. N., & Anjum, F. (2023, April 27). Hemodialysis. StatPearls - NCBI Bookshelf. https://www.ncbi.nlm.nih.gov/books/NBK563296/ Lewis, R. A., Bohm, C., Fraser, F., Fraser, R., Woytkiw, L., Jurgutis, S., Rubin, M., Smith, G., Buenafe, J., Verdin, N., Hutton, J., & Tonelli, M. (2022). Transportation burden associated with hemodialysis in Canada: A Qualitative study of Stakeholders. Kidney Medicine, 5(2), 100571. https://doi.org/10.1016/j.xkme.2022.100571 Fresenius Medical Care Asia-Pacific Ltd. (2023). Managing your time on dialysis | Fresenius Kidney Care | Philippines. https:// www.freseniuskidneycare.ph/staying-healthy/managing-time-on-dialysis Guo, J., Bard, J. F., Morrice, D. J., Jaen, C. R., & Poursani, R. (2021). Offering transportation services to economically disadvantaged patients at a family health center: a case study. Health Systems, 11(4), 251-275. https://doi.org/10.1080/20476965.2021.1936658