PSYCHOLOGICAL IMPACT OF COVID-19 IN HEMODIALYSIS PATIENTS

ABSTRACT

BACKGROUND AND AIMS: The COVID-19 pandemic has required containment measures in Morocco, as well as practice changes in haemodialysis centres. Haemodialysis patients are at risk of aggressive symptoms of COVID-19, which significantly increases mortality. This particular situation creates psychological disorders in those patients, such as anxiety, sleep disorders and irritability. The objective of our study is to assess the mental health status of haemodialysis patients during the pandemic and the psychological impact of confinement. This assessment will allow the adaptation of a supportive relationship with the patient through adequate psychological management. METHOD: This is a mono-centric, non-interventional study that included all haemodialysis patients at the haemodialysis centre of the nephrology department at Ibn Rochd University Hospital during the confinement period (March 2020- June 2020).This study is based on a pseudonymized paper questionnaire, during confinement, based on two psychiatric scores (GAD-7, PHQ-9) that assess anxiety, depression as well as sleep disorders, which allowed us to collect socio-demographic data, anxiety depressive symptomatology and an assessment of sleep disorders. RESULTS: The average age of our population is 47.4 years old, 54% of whom are men. Almost 34.54% have a primary level of education The higher level of education was 14.45%, while 14.54% are illiterate. Regarding family status, 45% are married. Those who are living alone accounted for 55%. Before confinement, 57.15% patients were daily workers;10 others had no work, among 3 of them were students;the 5 others were managers. After starting haemodialysis, 65.7% patients stopped their work. We noted that 38% of patients had a feeling of nervousness and anxiety for several days, while 9% had the same symptoms for more than half of the day. Concerning excessive anxiety, it was noted in 34% of patients for several days, while 16% showed excessive anxiety for more than half of the days. Concentration difficulties were noted in 41% of the patients for over several days and 5% more than half of days, while 58% of patients never had difficulties of concentration. The irritability feeling over several days was noted in 43% of patients, while 5.4% presented a feeling of irritability more than half of the days. Difficulty falling asleep is noted in 49% of patients, while 51% of patients have no difficulty falling asleep. The feelings of sadness, depression and despair are noted in 49% of patients for several days and 5% for more than half of the days. Sleep disorders were noted in 60% of patients on several days, while 40% had sleep disorders on more than half of the days. Loss of appetite was noted in 65% of patients. A lack of self-confidence was noted for several days in 43% of patients. 29% of patients lost the pleasure of having fun for several days. A total of 36% were slow or restless for several days. None of our patients expressed a desire to end their life, and 49% did not lose the pleasure of doing their daily activity. CONCLUSION: The mental health of dialysis patients assessed appears to be unaffected during this first wave of the pandemic. This could be due to high resilience, higher unemployment among dialysis patients, a reduced impact of social distancing on the haemodialysis population, strict precautionary measures and perceived support from health workers, who can all contribute to addressing this pandemic.