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

  1. Xiaoxiao Xia
  2. Xiaofang Wu
  3. Xueli Zhou
  4. Zhiyun Zang
  5. Li Pu
  6. Zi Li

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Abstract

<b><i>Background:</i></b> 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 CO­VID-19 in the patients undergoing dialysis and compare the difference between hemodialysis (HD) and peritoneal dialysis (PD) patients during the traffic lockdown period. <b><i>Methods:</i></b> 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. <b><i>Results:</i></b> 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) (<i>p</i> &#x3c; 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 (<i>p</i> &#x3c; 0.05). But more patients of both groups considered psychological support was necessary (HD: 50%, PD: 45.5%) (<i>p</i> &#x3e; 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 (<i>p</i> &#x3c; 0.05). <b><i>Conclusions:</i></b> 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.

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  1. Version published to 10.1159/000510553
  2. ScreenIT

    SciScore for 10.1101/2020.04.13.20063099: (What is this?)

    Please note, not all rigor criteria are appropriate for all manuscripts.

    Table 1: Rigor

    Institutional Review Board StatementConsent: The inclusion criteria were dialysis patients with ESRD over 18 years old and could use the smart phones to fulfill the questionnaires, consent was obtained before the data collection.
    Randomizationnot detected.
    Blindingnot detected.
    Power Analysisnot detected.
    Sex as a biological variablenot detected.

    Table 2: Resources

    Software and Algorithms
    SentencesResources
    Statistical Analyses: Statistical analysis was done with SPSS (version 21.0).
    SPSS
    suggested: (SPSS, RRID:SCR_002865)

    Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).

    Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:
    There were several limitations in our study. Firstly, the sample size was relatively small. We only included 232 dialysis patients in total, especially the small number in HD patients. Furthermore, smart phones were used to conduct the questionnaire survey. The information of some elderly patients was not available because they could not use smart phones. This might lead to non-respondent bias in our study. Maybe it would be better to use telephone survey for the elderly patients in future study. Until now, no precedent studies have reported on COVID-19-related stress for the dialysis patients. As far as we know, this is the first research comparing the psychological distress between HD and PD patients during the public health emergency. COVID-19 is still spreading worldwide and probably will last for a long period. Our study may have some practical significance for dialysis patients during this epidemic.

    Results from TrialIdentifier: No clinical trial numbers were referenced.

    Results from Barzooka: We did not find any issues relating to the usage of bar graphs.

    Results from JetFighter: We did not find any issues relating to colormaps.

    Results from rtransparent:
    • Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
    • Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
    • No protocol registration statement was detected.

    About SciScore

    SciScore is an automated tool that is designed to assist expert reviewers by finding and presenting formulaic information scattered throughout a paper in a standard, easy to digest format. SciScore checks for the presence and correctness of RRIDs (research resource identifiers), and for rigor criteria such as sex and investigator blinding. For details on the theoretical underpinning of rigor criteria and the tools shown here, including references cited, please follow this link.

  3. Version published to 10.1101/2020.04.13.20063099v1 on medRxiv