How Hemodialysis Patients Perceive the SARS-CoV-2 Health Crisis: Lessons from Austria

Abstract

BackgroundThe ongoing SARS-CoV-2 pandemic forced many countries to implement strict and unprecedented precautions to stop the spread of the virus. On top of these measures, hemodialysis units have adopted their own rules to protect wards and patients from infection with SARS-CoV-2. Despite the rapidly growing knowledge on epidemiology, virology, and clinical disease, little is known about how these measures are perceived by patients themselves on hemodialysis.MethodsThe study was performed in the three hemodialysis units in Vorarlberg, Austria’s westernmost state. A questionnaire was developed consisting of 22 questions on patients’ perceptions of the COVID-19 crisis and their feelings about the general precautions and specific steps implemented on dialysis wards. All adult patients were asked to fill out the questionnaire anonymously.ResultsOf 202 patients on hemodialysis, 148 completed the questionnaire (66.9% men, mean age 68.3±13.3 years). The vast majority (83.1%) were worried by the COVID-19 crisis, but only 28.4% reported a negative effect on emotional well-being. Daily life was most affected by the general ban on visitors (58.6%) and home confinement (35.9%). Of the patients, 64.2% feared contracting COVID-19, 30.7% were afraid of financial consequences, and 14.6% were afraid of loneliness and isolation. The safety measures on dialysis wards were classified as adequate by 97.3% of the respondents. Of the patients, 78.2% felt safe during dialysis treatment. All dialysis-specific precautions (individual patient transport, health check, hand disinfection, wearing a face mask, and physical distancing) were rated important or very important by almost all patients. To date, none of the patients have acquired SARS-CoV-2 infection.ConclusionsAlthough the SARS-CoV-2 crisis brought worry to and affected the lives of most patients on hemodialysis, its effect on their emotional well-being was moderate. Patients felt safe on dialysis wards, and acceptance of specific precautions was high.

Effects of self-management education on COVID-19 prevention in patients undergoing hemodialysis

“…The participants’ degree of fear of COVID-19 before providing education was 7.21/10 points, which was higher than that (6.3–6.8 points) in a study investigating 10,368 adult participants [ 24 ] and even higher than that (5.17 points) in cancer patients [ 25 ]. Considering the results showing that 64.2% of patients on hemodialysis [ 26 ] and 79–90% of patients with cancer [ 27 , 28 ] complained of fear of infection and delays in treatment, it is assumed that the patients with chronic illnesses who are scheduled for periodic medical treatment are more likely to fear infection than healthy adults because they have to visit medical centers to receive treatment with other patients in confined spaces [ 9 ] and may have concerns regarding problems with their treatment schedule [ 27 ].…”

Impact of the COVID-19 Pandemic on the Provision of Dialysis Service and Mortality in Veterans Receiving Maintenance Hemodialysis in the VA: An Interrupted Time-Series Analysis

“…During the months of May and June 2020, all-cause mortality was 26% higher than that during 2017-2019. The higher mortality during the early pandemic months is likely due to missed dialysis treatments [22][23][24][25][26]. Thus, the more modest increase in mortality in Veteran patients receiving maintenance hemodialysis in the VA is likely due to lack of disruption in the delivery and receipt of dialysis treatments which involve both patient and systemrelated factors.…”

Dialysis Patient Experiences During the COVID-19 Pandemic: A Survey Study

“…Data on the experience of patients receiving maintenance dialysis during the COVID-19 pandemic are sparse, 11 , 12 , 13 , 14 and has mostly focused on quantification of mental health conditions or health related quality of life. Previous studies have noted that experiences may vary for patients treated with different dialysis modalities 15 , 16 and for patients with pre-existing mental health conditions.…”