University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania.
Department of Surgery, Psychiatry and Psychology, University of Pittsburgh, Pittsburgh, Pennsylvania.
Kidney360. 2020 Oct 20;1(12):1390-1397. doi: 10.34067/KID.0004662020. eCollection 2020 Dec 31.
The coronavirus disease 2019 (COVID-19) may have a negative effect on the mental and social health of patients with ESKD on chronic in-center hemodialysis (HD), who have a high burden of psychologic symptoms at baseline and unavoidable treatment-related COVID exposures. The goal of our study was to assess the effect of the COVID-19 pandemic on the psychosocial health of patients on chronic in-center HD.
Participants enrolled in the ongoing Technology Assisted Collaborative Care (TĀCcare) trial in Western Pennsylvania and New Mexico were approached for participation in a phone survey in May 2020. Data on the pandemic's effects on participants' physical and mental health, symptoms (such as anxiety, mood, loneliness, sleep, and stress), and food and housing security were collected.
Surveys were completed by 49 participants (mean age 56 years; 53% men, 18% Black, 20% American Indian, and 22% Hispanic). Almost 80% of participants reported being moderately to extremely worried about the pandemic's effects on their mental/emotional health and interpersonal relationships. More than 85% of the participants were worried about obtaining their dialysis treatments due to infection risk from close contact in the dialysis facility or during transportation. Despite this, 82% of participants reported being not at all/slightly interested in trying home dialysis as an alternative option. Overall, 27% of the participants had clinical levels of depressive symptoms but only 12% had anxiety meeting clinical criteria. About 33% of participants reported poor sleep quality over the last month. Perceived stress was high in about 30% of participants and 85% felt overwhelmed by difficulties with COVID-19, although 41% felt that things were fairly/very often going their way.
Our study provides preliminary insights into the psychosocial distress caused by the COVID-19 pandemic among a diverse cohort of patients receiving chronic HD who are participating in an ongoing clinical trial.
2019 年冠状病毒病（COVID-19）可能对接受慢性中心血液透析（HD）的终末期肾病（ESKD）患者的精神和社会健康产生负面影响，这些患者在基线时已经存在大量的心理症状，并且不可避免地会接触到与 COVID 相关的治疗。我们研究的目的是评估 COVID-19 大流行对接受慢性中心 HD 的患者的社会心理健康的影响。
我们邀请了宾夕法尼亚州西部和新墨西哥州正在进行的技术辅助协作护理（TĀCcare）试验的参与者参加 2020 年 5 月的电话调查。收集了有关大流行对参与者身心健康、症状（如焦虑、情绪、孤独、睡眠和压力）以及食物和住房保障的影响的数据。
共完成了 49 名参与者的调查（平均年龄 56 岁；53%为男性，18%为黑人，20%为美国印第安人，22%为西班牙裔）。近 80%的参与者报告说，他们对大流行对其精神/情绪健康和人际关系的影响感到中度到极度担忧。超过 85%的参与者担心因在透析机构内或在运输过程中与他人密切接触而感染 COVID-19，从而无法获得透析治疗。尽管如此，82%的参与者表示对尝试家庭透析作为替代方案一点也不感兴趣。总的来说，27%的参与者有临床水平的抑郁症状，但只有 12%的参与者有焦虑符合临床标准。大约 33%的参与者报告说过去一个月睡眠质量差。约 30%的参与者感到压力很大，85%的参与者感到因 COVID-19 而不知所措，尽管 41%的参与者觉得事情经常对他们有利。
我们的研究初步探讨了正在参与一项正在进行的临床试验的接受慢性 HD 的患者中，COVID-19 大流行所导致的社会心理困扰。
