SEARCHCROSS-SECTIONALnephrology, internal medicine

cross-sectional·nephrology, internal medicine, psychiatry, epidemiology, public health·PMC10186967

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

Kidney Medicine · 10 authors, 6 centres

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TL;DR

A survey study of 172 dialysis patients found that perceptions of their dialysis care were largely unchanged early in the COVID-19 pandemic, though other life aspects like social interactions and access to support were impacted.

Full summary

875 CHARS

This cross-sectional survey study of 172 adult dialysis patients aimed to define how their care experiences were affected by the COVID-19 pandemic. Surveys, including Likert scale and open-ended questions, were administered verbally after the first pandemic wave. Results showed most patients did not feel their dialysis care had changed, with 68% reporting this and many feeling connected to care teams. Thematic analysis identified four themes, including the value of care team consistency and the importance of external social support. Limitations include the single-center design, early timing of surveys without reassessment, and lack of power for statistical analysis. Implications suggest that while dialysis care was resilient, patients with histories of mental health conditions, non-White patients, and those on in-center hemodialysis may have been more vulnerable.

STUDY TYPE

cross-sectional

SPECIALTY

nephrology

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AI pipeline

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100% · A

ORIGINAL PAPER

PMC10186967

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

Kidney Medicine

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ABSTRACT

Abstract Rationale & Objective The coronavirus disease 2019 (COVID-19) pandemic imposed several changes in the care of patients with kidney failure receiving dialysis. We explored patient care experiences during the pandemic. Study Design The study team verbally administered surveys including Likert scale multiple-choice questions and open-ended questions and recorded responses. Setting & Participants Surveys were administered to adults receiving dialysis through an academic nephrology practice after the first wave of the COVID-19 pandemic. Exposure Outpatient dialysis treatment during the COVID-19 pandemic. Outcomes Perceptions of care and changes in health. Analytical Approach Multiple-choice responses were quantified using descriptive statistics. Thematic analysis was used to code open-ended responses and derive themes surrounding patient experiences. Results A total of 172 patients receiving dialysis were surveyed. Most patients reported feeling “very connected” to the care teams. Seventeen percent of participants reported transportation issues, 6% reported difficulty obtaining medications, and 9% reported difficulty getting groceries. Four themes emerged as influencing patient experiences during the pandemic: 1) the COVID-19 pandemic did not significantly affect participants’ experience of dialysis care; 2) the COVID-19 pandemic significantly impacted other aspects of participants’ lives, which in turn were felt to affect mental and physical health; 3) regarding dialysis care experience more generally, participants valued consistency, dependability, and personal connection to staff; and 4) the COVID-19 pandemic highlighted the importance of external social support. Limitations Surveys were administered early in the COVID-19 pandemic, and patient perspectives have not been reassessed. Further qualitative analysis using semi-structured interviews was not performed. Survey distribution in additional practice settings, using validated questionnaires, would increase generalizability of the study. The study was not powered for statistical analysis. Conclusions Early in the COVID-19 pandemic, perceptions of dialysis care were unchanged for most patients. Other aspects of participants’ lives were impacted, which affected their health. Subpopulations of patients receiving dialysis may be more vulnerable during the pandemic: those with histories of mental health conditions, non-White patients, and patients treated by in-center hemodialysis. Plain-language summary Patients with kidney failure continue to receive life-sustaining dialysis treatments during the coronavirus disease 2019 (COVID-19) pandemic. We sought to understand perceived changes in care and mental health during this challenging time. We administered surveys to patients receiving dialysis after the initial wave of COVID-19, asking questions on topics including access to care, ability to reach care teams, and depression. Most participants did not feel that their dialysis care experiences had changed, but some reported difficulties in other aspects of living such as nutrition and social interactions. Participants highlighted the importance of consistent dialysis care teams and the availability of external support. We found that patients who are treated with in-center hemodialysis, are non-White, or have mental health conditions may have been more vulnerable during the pandemic. Index Words: Kidney failure, end stage kidney disease, dialysis, kidney replacement therapy, patient experience, perceptions of care, access to care, mental health, COVID-19 pandemic

CITATION EXPORT

Elyssa M Noce, Laura Brereton, Mary Zorzanello et al.. Dialysis Patient Experiences During the COVID-19 Pandemic: A Survey Study. Kidney Medicine. (2023). https://doi.org/10.1016/j.xkme.2023.100673

AUTHORS

10 · 6 CENTRES

Elyssa M Noce, Laura Brereton, Mary Zorzanello, Abinet Aklilu, Elizabeth Anders, Melia Bernal, Anusha Sundararajan, Neera K Dahl, Ravi Kodali, Dipal M Patel

1Department of Internal Medicine, Section of Nephrology, Yale-New Haven Hospital, New Haven, Connecticut
2Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada
3Department of Internal Medicine, Section of Nephrology, Yale School of Medicine, New Haven, Connecticut
4School of Nursing, Yale University, New Haven, Connecticut
5School of Public Health, Yale University, New Haven, Connecticut
6Department of Internal Medicine, Division of Nephrology, Johns Hopkins Medicine, Baltimore, Maryland