Introduction
In march 2020, Tunisia confirmed its first novel coronavirus cases joining with that the global health crisis due to COVID-19 pandemic. The psychological impacts of this pandemic were reported in multiple studies. Mental health struggles had been proven particularly in chronic disease patients.
The aim of this study was to assess the psychological impact of COVID-19 pandemic and its associated factors among chronic hemodialysis patients.
Methods
It was a cross-sectional study carried out in patients of the HD center of Sfax CNSS policlinic, Tunisia, in April 2021, during the fourth wave of COVID-19. All patients that participated in the survey were asked to answer three questionnaires.
The first questionnaire was the impact of events scale-revised(IES-r) used to evaluate the post-traumatic stress disorder (PTSD). The global health questionnaire (GHQ-12) was applied to detect psychological distress, it consists of four sub-components that measure anxiety, insomnia, social dysfunction and depression. The ratio of 2 is considered the criterion for positif GHQ score. The psychological distress is considered severe if the score reaches 8. We used a third questionnaire with additional questions investigating socio-economic features, worries and daily life stressful situations specific to HD patients.
Results
Thirty one out of 45 patients accepted to participate in our study (response rate =68,8%). Informed oral consent was obtained from each patient prior to the survey. General data, demographics and health status are summarized in Table 1.
The most prevalent fear of our patients was to contract the covid-19 virus (64.5%) or to transmit the infection to other household members (67%). However, 83,3% of patients felt no particular influence of the pandemic on their chronic disease management or on their daily life. Also, 64,5% felt a satisfying psychological support and 83,5% said they received clear informations about pandemic from the healthcare team. Practically, all patients felt that it’s possible to overcome their chronic disease during the pandemic.
GHQ-12 identified significant results with a mean score at 4,53 [0-11]. Twenty-three patients had a positive GHQ score. Three of them had a score equal or greater than 8 and were considered in a severe psychological distress. For IES-r, 11 patients had scores equal or greater than 36 which represents the best cutoff for a probable diagnosis of PTSD.
Conclusions
In this study, nearly half of our HD patients had psychological problems due to COVID-19 pandemic despite the good psychological support established in the unit. Mental health problems should be screened early especially in this particularly vulnerable population. Patients with the highest scores should be referred to psychological care.
No conflict of interest