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比较在封锁期间腹膜透析和血液透析患者的心理困扰和需求:一家三级医院的横断面研究。

Comparison of Psychological Distress and Demand Induced by COVID-19 during the Lockdown Period in Patients Undergoing Peritoneal Dialysis and Hemodialysis: A Cross-Section Study in a Tertiary Hospital.

机构信息

Department of Nephrology, West China Hospital of Sichuan University, Chengdu, China.

West China School of Medicine, Sichuan University, Chengdu, China.

出版信息

Blood Purif. 2021;50(3):319-327. doi: 10.1159/000510553. Epub 2020 Oct 28.

Abstract

BACKGROUND

Since the outbreak of COVID-19 in December 2019, it has spread rapidly and widely, bringing great psychological pressure to the public. In order to prevent the epidemic, traffic lockdown was required in many areas of China, which led to inconvenience of treatment for dialysis patients. This study was conducted to explore the psychological distress and the psychological demand induced by CO-VID-19 in the patients undergoing dialysis and compare the difference between hemodialysis (HD) and peritoneal dialysis (PD) patients during the traffic lockdown period.

METHODS

Questionnaires were given to the dialysis patients in the West China Hospital of Sichuan University. The Impact of Event Scale (IES) was used to investigate the patients' trauma-related distress in response to COVID-19.

RESULTS

232 eligible respondents were enrolled in this cross-section study, consisting of 156 PD patients and 76 HD patients. The median IES score for all the enrolled patients was 8.00 (2.00-19.00), which belonged to the subclinical dimension of post-traumatic stress symptoms (PTSS). HD patients had a significant higher IES score than PD patients (11.50 vs. 8.00) (p < 0.05). HD patients already got more psychological support from the medical staff. According to IES scores, 22.4% HD patients and 13.4% PD patients were classified as having moderate or severe PTSS, which need psychological support (p < 0.05). But more patients of both groups considered psychological support was necessary (HD: 50%, PD: 45.5%) (p > 0.05). In the multivariate regression analysis, we found that dialysis vintage, the impact of COVID-19 on the severity of illness and daily life, and confidence in overcoming the disease contributed to IES score (p < 0.05).

CONCLUSIONS

HD patients had more severe trauma-related stress symptoms than PD patients. When major public healthy events occurred, careful psychological estimate and sufficient psychological support should be provided to the dialysis patients, especially to the HD patients.

摘要

背景

自 2019 年 12 月 COVID-19 爆发以来,其迅速广泛传播,给公众带来了巨大的心理压力。为了预防疫情,中国许多地区都实行了交通封锁,这导致透析患者的治疗不便。本研究旨在探讨 COVID-19 期间透析患者的心理困扰和心理需求,并比较交通封锁期间血液透析(HD)和腹膜透析(PD)患者之间的差异。

方法

本研究对四川大学华西医院的透析患者进行了问卷调查。采用事件影响量表(IES)调查 COVID-19 对患者创伤相关的困扰。

结果

本横断面研究共纳入 232 名符合条件的透析患者,包括 156 名 PD 患者和 76 名 HD 患者。所有入组患者的 IES 评分中位数为 8.00(2.00-19.00),属于创伤后应激症状(PTSS)的亚临床维度。HD 患者的 IES 评分显著高于 PD 患者(11.50 比 8.00)(p<0.05)。HD 患者已经从医务人员那里获得了更多的心理支持。根据 IES 评分,22.4%的 HD 患者和 13.4%的 PD 患者被归类为有中度或重度 PTSS,需要心理支持(p<0.05)。但两组都有更多的患者认为需要心理支持(HD:50%,PD:45.5%)(p>0.05)。在多变量回归分析中,我们发现透析龄、COVID-19 对疾病严重程度和日常生活的影响,以及对战胜疾病的信心都与 IES 评分有关(p<0.05)。

结论

HD 患者的创伤相关应激症状比 PD 患者更严重。当发生重大公共卫生事件时,应仔细评估透析患者的心理状况,并为他们提供充足的心理支持,尤其是 HD 患者。

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