key: cord-0702319-mwpsumym authors: Davis, Michael J.; Alqarni, Khaled A.; McGrath‐Chong, Margaret E.; Bargman, Joanne M.; Chan, Christopher T. title: Anxiety and psychosocial impact during coronavirus disease 2019 in home dialysis patients date: 2021-10-06 journal: Nephrology (Carlton) DOI: 10.1111/nep.13978 sha: c62ad74ef0fe44790e6a48c550c50d67b6ab7cdf doc_id: 702319 cord_uid: mwpsumym The severe acute respiratory syndrome coronavirus (SARS‐Cov‐2) resulting in the coronavirus disease 2019 (COVID‐19) is documented to have a negative psychosocial impact on patients. Home dialysis patients may be at risk of additional isolating factors affecting their mental health. The aim of this study is to describe levels of anxiety and quality of life during the COVID‐19 pandemic among home dialysis patients. This is a single‐centre survey of home dialysis patients in Toronto, Ontario. Surveys were sent to 98 home haemodialysis and 43 peritoneal dialysis patients. Validated instruments (Haemodialysis and Peritoneal Dialysis Treatment Satisfaction Questionnaire, Generalized Anxiety Disorder 7 Item [GAD7] Scale, Patient Health Questionnaire [PHQ‐9], Illness Intrusiveness Ratings Scale, Family APGAR Questionnaire and The Self Perceived Burden Scale) assessing well‐being were used. Forty of the 141 patients surveyed, participated in September 2020. The mean age was 53.1 ± 12.1 years, with 60% male, and 85% home haemodialysis, 80% of patients rated their satisfaction with dialysis at 8/10 or greater, 82% of respondents reported either “not at all” or “for several days” indicating frequency of anxiety and depressive symptoms, 79% said their illness minimally or moderately impacted their life, 76% of respondents were almost always satisfied with interactions with family members, 91% were never or sometimes worried about caregiver burden. Among our respondents, there was no indication of a negative psychosocial impact from the pandemic, despite the increased social isolation. Our data further supports the use of home dialysis as the optimal form of dialysis. The World Health Organization (WHO) declared a global pandemic on March 11, 2020 , in response to the emergence and rapid spread of the severe acute respiratory syndrome coronavirus resulting in the coronavirus disease 2019 . The WHO warned of a natural psychological response involving anxiety and distress from these rapidly changing conditions. 1 Experience from previous pandemics, including the severe acute respiratory syndrome coronavirus (SARS-Cov-1) pandemic from 2003, demonstrated that global pandemics have a significant effect on mental well-being including fear of contraction and spreading infection to family members, loneliness, anxiety, depression and suicide. 2 Reasons include national lockdowns to contain virus spread resulting in isolation and family separation, panic and hysteria propagated by the vast spread of often-inaccurate information via social media, lack of basic needs and financial losses and the fear and vulnerability associated with the uncertainty of disease progression. 2, 3 This fear of disease progression may be increased in dialysis patients given their baseline medical comorbidities. Chronic dialysis patients had an increased risk of severe COVID-19 infection-related complications, intubation and mortality, particularly in patients aged 60-79 years old. 4 Therefore, we hypothesize that end stage renal disease (ESRD) patients performing home dialysis may have a high level of anxiety and psychological distress secondary to the effects of the COVID-19 pandemic on mental health. The survey was sent to 141 participants in September 2020, of which 40 returned a completed survey. The mean age was 53.1 ± 12.1 years, and the mean length of time on dialysis was 165.3 ± 135.8 months, 60% of participants were male, 85% used haemodialysis, and 63% were currently married. In There were two responses deemed adverse events. The first was from a home haemodialysis patient who, because of issues with his arteriovenous fistula, reported struggling daily and did not have the energy to complete the survey at the time. The second was from a patient who declined to participate as he felt effectively isolated prior to the COVID-19 pandemic and therefore was disinterested. Both patients were offered medical care and mental health counselling assistance by the research team. In conclusion, there does not appear to be excessive stress from the presence of the COVID-19 pandemic on patients receiving dialysis at home. Even though both the pandemic and being on dialysis carry significant stressors, there does not appear to be an additive burden. For this group, home therapy is a feasible technique, supporting it as the optimal form of dialysis therapy. Coronavirus Disease (COVID-19) Pandemic The psychosocial effects of being quarantined following exposure to SARS: a qualitative study of Toronto health care workers The pandemic of social media panic travels faster than the COVID-19 outbreak Patients with chronic kidney disease have a poorer prognosis of coronavirus disease 2019 (COVID-19): an experience in Hemodialysis and peritoneal dialysis: patients' assessment of their satisfaction with therapy and the impact of the therapy on their lives A brief measure for assessing generalized anxiety disorder: the GAD-7 The PHQ-9: validity of a brief depression severity measure The emotional impact of end-stage renal disease: importance of patients' perceptions of intrusiveness and control The family APGAR: a proposal for a family function test and its use by physicians Measuring chronic patients' feelings of being a burden to their caregivers: development and preliminary validation of a scale Research electronic data capture (REDCap)-a metadata-driven methodology and workflow process for providing translational research informatics support Psychosocial factors in dialysis patients Prevalence of depression in chronic kidney disease: systematic review and meta-analysis of observational studies Course of depression and anxiety diagnosis in patients treated with hemodialysis: a 16-month follow-up 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 Anxiety and psychosocial impact during coronavirus disease 2019 in home dialysis patients The authors declare no conflicts of interest. https://orcid.org/0000-0003-3647-5297Christopher T. Chan https://orcid.org/0000-0002-0947-7273