How do Hemodialysis Patients Perceive the Coronavirus Pandemic? Survey Results

Surveyed Population

The study, which took place during the second week of April 2020 (four weeks after the nationwide lockdown was declared) in three hemodialysis departments in the Austrian state of Vorarlberg, included a total of 148 patients (66.9% men; average age 68.3 years). The participants completed a 22-question questionnaire focused on their perception of the COVID-19 pandemic and anti-epidemic measures and their impact on the patients' mental health. At that time, they had been on hemodialysis for an average of 28.5 months. 66.7% lived with family, 23.6% lived alone, and 5.6% lived in nursing homes. The respondents were divided into three age groups: < 65 years, 65–77 years, and > 77 years.

Results

The majority of patients (83.1%) were concerned about the COVID-19 pandemic, but only 18.2% felt very worried. The main concern for 64.2% of patients was viral infection, for 30.7% it was financial impact, and 14.6% were mainly afraid of social isolation and loneliness. A negative impact on mental health was reported by 28.4% of patients (27% of men vs. 41.3% of women; p = 0.04). Their daily life was mainly affected by the ban on visits (58.6% of patients) and home quarantine (35.9%). Only 28.6% of patients reported that the anti-epidemic measures had no impact on their daily life.

The vast majority of patients (97.3%) rated the anti-epidemic measures in the hemodialysis departments as adequate. Only a few considered them insufficient or exaggerated. During visits to the hemodialysis department, 78.2% of patients felt safe regarding the risk of COVID-19. Measures including individual transport to dialysis, body temperature measurement, hand disinfection, mouth and nose protection, and social distancing were considered adequate by most patients. None of the patients surveyed was tested positive for COVID-19 at the time of the study. Only a small part of the respondents suggested using more suitable protective equipment, larger distances, or more frequent COVID-19 testing for greater safety.

Patients were also asked whether they felt they were at increased risk of infection. Half of them (51%) considered themselves at risk, especially in the age group of 65–77 years. 23% reported that they did not feel at increased risk, and 25.6% had no clear opinion on this matter.

Almost all patients (99.3%) stated that they received adequate medical care despite the COVID-19 pandemic. More than a tenth (12.3%) also perceived their stay in medical facilities positively as a welcome change from daily routine and social isolation.

Discussion and Conclusion

The impact of the coronavirus pandemic on the mental health of hemodialysis patients appears to be rather mild. Although most were concerned about the epidemic and restricted by anti-epidemic measures, only a minority felt significant anxiety and negative effects on their daily lives. Concerns about financial impacts may not have been predominant, as most patients were already retired. Two-thirds of the patients lived with family, so fears of loneliness and social isolation were not as significant.

The study may be limited by the fact that the state of Vorarlberg was only mildly affected by the COVID-19 pandemic. Additionally, information on the psychological state of the patients before the pandemic is missing.

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Source: Davidovic T., Sprenger-Mähr H., Abbassi-Nik A. et al. How hemodialysis patients perceive the SARS-CoV-2 health crisis: lessons from Austria. Kidney360 2020; 1 (10): 1077–1082, doi: 10.34067/KID.0003582020.