Fatigue, Anxiety and Depression due to the Challenges faced by Patients undergoing Hemodialysis and their Caregivers during Covid-19 Pandemic
Main Article Content
Abstract
Background: Covid-19 outbreak is found to be associated with increased levels mental health issues among the general population. The high prevalence of fatigue, anxiety and depression was also reported in patients on hemodialysis during Covid-19 pandemic as compared to pre-pandemic studies.
Aims: This article determines the level of fatigue, anxiety and depression due to the challenges faced by patients undergoing hemodialysis and their caregivers during the Covid-19 pandemic.
Methods: This descriptive cross-sectional study was carried out in hemodialysis unit of a tertiary care hospital over the period of 3 months from August to October 2021, using validated questionnaire consisted of Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-F) and Hospital Anxiety and Depression Scale (HADS).
Results: Among 115 patients (age; mean 53.45 ± 13.9 S.D), fatigue was seen in 80%, anxiety in 67%, depression in 82.6%. While in their caregivers, the prevalence of fatigue was 73.6%, anxiety was 52.7%, depression was 59.1%. Logistic regression analysis showed that gender and challenges e.g. feeling additional burden while visiting the hospital and fear of getting infection and feeling of isolation/loneliness were the main risk predictors of fatigue, anxiety and depression in patients and their caregivers.
Conclusions: In Pakistan the prevalence of fatigue, anxiety and depression due to the challenges of Covid-19 pandemic was significantly high among patients undergoing hemodialysis and their caregivers as compared to pre-covid era. This study gives firm grounds for future researches, which should ascertain the suitable interventions to lessen the fatigue, anxiety, and depression due to the challenges of any future pandemic or epidemic among patients undergoing hemodialysis and their family members.
Keywords:
Covid-19, Hemodialysis, Fatigue, Anxiety, Depression, Challenges, Caregivers, Pakistan
Article Details
How to Cite
JALEEL, Hadiqa et al.
Fatigue, Anxiety and Depression due to the Challenges faced by Patients undergoing Hemodialysis and their Caregivers during Covid-19 Pandemic.
Medical Research Archives, [S.l.], v. 10, n. 9, sep. 2022.
ISSN 2375-1924.
Available at: <https://esmed.org/MRA/mra/article/view/3058>. Date accessed: 26 apr. 2024.
doi: https://doi.org/10.18103/mra.v10i9.3058.
Section
Research Articles
The Medical Research Archives grants authors the right to publish and reproduce the unrevised contribution in whole or in part at any time and in any form for any scholarly non-commercial purpose with the condition that all publications of the contribution include a full citation to the journal as published by the Medical Research Archives.
References
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14. Corbett RW, Blakey S, Nitsch D, et al. Epidemiology of COVID-19 in an urban dialysis center. Journal of the American Society of Nephrology. 2020;31(8):1815-1823.
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19. Meherali S, Punjani N, Louie-Poon S, et al. Mental health of children and adolescents amidst COVID-19 and past pandemics: a rapid systematic review. International journal of environmental research public health. 2021;18(7):3432.
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28. Yellen SB, Cella DF, Webster K, Blendowski C, Kaplan EJJop. Measuring fatigue and other anemia-related symptoms with the Functional Assessment of Cancer Therapy (FACT) measurement system. Journal of pain symptom management. 1997;13(2):63-74.
29. Al Maqbali M, Hughes C, Gracey J, Rankin J, Hacker E, Dunwoody L. Psychometric properties of the Arabic version of the Functional Assessment of Chronic Illnesses Therapy–Fatigue in Arabic cancer patients. Journal of Pain and Symptom Management. 2020;59(1):130-138. e132.
30. Zigmond AS, Snaith RP. The hospital anxiety and depression scale. Acta psychiatrica scandinavica. 1983;67(6):361-370.
31. Bjelland I, Dahl AA, Haug TT, Neckelmann D. The validity of the Hospital Anxiety and Depression Scale: an updated literature review. Journal of psychosomatic research. 2002;52(2):69-77.
32. Terkawi AS, Tsang S, AlKahtani GJ, et al. Development and validation of Arabic version of the Hospital Anxiety and Depression Scale. Saudi journal of anaesthesia. 2017;11(Suppl 1):S11.
33. Chen C-K, Tsai Y-C, Hsu H-J, et al. Depression and suicide risk in hemodialysis patients with chronic renal failure. Psychosomatics. 2010;51(6):528-528. e526.
34. Bonenkamp AA, Druiventak TA, van Eck van der Sluijs A, van Ittersum FJ, van Jaarsveld BC, Abrahams AC. The Impact of COVID-19 on the mental health of dialysis patients. Journal of nephrology. 2021;34(2):337-344.
35. Hou T, Zhang R, Song X, et al. Self-efficacy and fatigue among non-frontline health care workers during COVID-19 outbreak: A moderated mediation model of posttraumatic stress disorder symptoms and negative coping. PloS one. 2020;15(12):e0243884.
36. Salari N, Hosseinian-Far A, Jalali R, et al. Prevalence of stress, anxiety, depression among the general population during the COVID-19 pandemic: a systematic review and meta-analysis. Globalization health. 2020;16(1):1-11.
37. Wang C, Pan R, Wan X, et al. Immediate psychological responses and associated factors during the initial stage of the 2019 coronavirus disease (COVID-19) epidemic among the general population in China. International journal of environmental research public health. 2020;17(5):1729.
38. Wang C, Pan R, Wan X, et al. A longitudinal study on the mental health of general population during the COVID-19 epidemic in China. Brain, behavior, immunity. 2020;87:40-48.
39. Bawazier LA, Stanley I, Sianipar W, Suhardjono S. Anxiety and depression among caregivers of hemodialysis patients at the Indonesian national referral hospital. Medical Journal of Indonesia. 2018;27(4):271-278.
40. Gerogianni G, Polikandrioti M, Babatsikou F, et al. Anxiety–depression of dialysis patients and their caregivers. Medicina. 2019;55(5):168.
41. Keskin G, Engin E. The evaluation of depression, suicidal ideation and coping strategies in haemodialysis patients with renal failure. Journal of clinical nursing. 2011;20(19‐20):2721-2732.
42. Jace CE, Makridis CA. Does marriage protect mental health? Evidence from the COVID‐19 pandemic. Social Science Quarterly. 2021;102(6):2499-2515.
43. Ta VP, Gesselman AN, Perry BL, Fisher HE, Garcia JR. Stress of singlehood: Marital status, domain-specific stress, and anxiety in a national US sample. Journal of Social Clinical Psychology. 2017;36(6):461-485.
44. Dilmaç B, Karababa A, Seki T, Şimşir Z, Kurnaz MF. Examining the Relationships Between Fear of Coronavirus, State Anxiety, and Relationship Happiness Among Married Turkish Individuals During COVID-19. Journal of Family Issues. 2021:0192513X211055513.
45. Adejumo OA, Iyawe IO, Akinbodewa AA, Abolarin OS, Alli EOJGMJ. Burden, psychological well-being and quality of life of caregivers of end stage renal disease patients. 2019;53(3):190-196.
46. García‐Fernández L, Romero‐Ferreiro V, Padilla S, et al. Gender differences in emotional response to the COVID‐19 outbreak in Spain. Brain. 2021;11(1):e01934.
47. Özdin S, Bayrak Özdin Ş. Levels and predictors of anxiety, depression and health anxiety during COVID-19 pandemic in Turkish society: The importance of gender. International Journal of Social Psychiatry. 2020;66(5):504-511.
48. Zhang W, Walkover M, Wu YY. The challenge of COVID-19 for adult men and women in the United States: disparities of psychological distress by gender and age. Public Health. 2021;198:218-222.
49. Donnelly R, Farina MP. How do state policies shape experiences of household income shocks and mental health during the COVID-19 pandemic? Social science medicine.2021;269:113557.
50. Zarrouq B, Abbas N, El Hilaly J, et al. An investigation of the association between religious coping, fatigue, anxiety and depressive symptoms during the COVID-19 pandemic in Morocco: a web-based cross-sectional survey. BMC psychiatry. 2021;21(1):1-13.
51. Zhang H. The influence of the ongoing COVID-19 pandemic on family violence in China. Journal of family violence. 2020:1-11.
52. Zoumpourlis V, Goulielmaki M, Rizos E, Baliou S, Spandidos DA. [Comment] The COVID‑19 pandemic as a scientific and social challenge in the 21st century. Molecular medicine reports. 2020;22(4):3035-3048.
53. Jahrami H, BaHammam AS, Bragazzi NL, Saif Z, Faris M, Vitiello MV. Sleep problems during the COVID-19 pandemic by population: a systematic review and meta-analysis. Journal of Clinical Sleep Medicine. 2021;17(2):299-313.
54. Kalwar HA, Kamani L. Problems faced by patients and health service utilization experiences of gastrointestinal patients during lockdown due to COVID-19 pandemic. Pakistan Journal of Medical Sciences. 2022;38(3Part-I):517.
55. Iqbal S, Iqbal A, Blair KAA, et al. Challenges faced by the patients on dialysis treatment in COVID-19 era and the possible solutions. Biomed J Sci Tech Res. 2021;36:28279-28282.
56. Sannes TS, Yeh IM, Gray TFJP-o. Caring for loved ones with cancer during the COVID‐19 pandemic: a double hit risk for social isolation and need for action. 2020.
2. Cucinotta D, Vanelli M. WHO declares COVID-19 a pandemic. Acta Bio Medica: Atenei Parmensis. 2020;91(1):157.
3. Organization WH. Global Statistics of Covid-19. 2022; https://covid19.who.int/. Accessed 28 January, 2022.
4. Abid K, Bari YA, Younas M, Tahir Javaid S, Imran AJAPJoPH. Progress of COVID-19 Epidemic in Pakistan. 2020;32(4):154-156.
5. Dashborad C-. Statisctics of Covid-19 in Pakistan. 2022; https://covid.gov.pk/stats/pakistan.
6. Farooq S, Haider SI, Sachwani S, Parpio YN. Insight into COVID-19 responses and initiatives from Pakistan. Journal of the College of Physicians and Surgeons--Pakistan: JCPSP. 2020.
7. Saeed U, Sherdil K, Ashraf U, Younas I, Butt H, Ahmad S. Identification of potential lockdown areas during COVID-19 transmission in Punjab, Pakistan. Public health. 2021;190:42-51.
8. Bajgain KT, Badal S, Bajgain BB, Santana MJ. Prevalence of comorbidities among individuals with COVID-19: A rapid review of current literature. American journal of infection control. 2021;49(2):238-246.
9. Ejaz H, Alsrhani A, Zafar A, et al. COVID-19 and comorbidities: Deleterious impact on infected patients. Journal of infection & public health. 2020;13(12):1833-1839.
10. Black C, Sharma P, Scotland G, et al. Early referral strategies for management of people with markers of renal disease: a systematic review of the evidence of clinical effectiveness, cost-effectiveness and economic analysis. Health Technology Assessment. 2010;14(21):1-184.
11. Himmelfarb J, Ikizler TA. Hemodialysis. New England Journal of Medicine. 2010;363(19):1833-1845.
12. Hasan M, Sutradhar I, Gupta RD, Sarker M. Prevalence of chronic kidney disease in South Asia: a systematic review. BMC nephrology. 2018;19(1):1-12.
13. Imtiaz S, Salman B, Qureshi R, Drohlia MF, Ahmad A. A review of the epidemiology of chronic kidney disease in Pakistan: A global and regional perspective. Saudi Journal of Kidney DiseasesTransplantation.` 2018;29(6):1441.
14. Corbett RW, Blakey S, Nitsch D, et al. Epidemiology of COVID-19 in an urban dialysis center. Journal of the American Society of Nephrology. 2020;31(8):1815-1823.
15. Albalate M, Arribas P, Torres E, et al. High prevalence of asymptomatic COVID-19 in hemodialysis. Daily learning during first month of COVID-19 pandemic. Nefrología. 2020;40(3):279-286.
16. Goicoechea M, Cámara LAS, Macías N, et al. COVID-19: clinical course and outcomes of 36 hemodialysis patients in Spain. Kidney international. 2020;98(1):27-34.
17. La Milia V, Bacchini G, Bigi MC, et al. COVID-19 outbreak in a large hemodialysis center in Lombardy, Italy. Kidney international reports. 2020;5(7):1095-1099.
18. Salerno S, Messana JM, Gremel GW, et al. COVID-19 Risk Factors and Mortality Outcomes Among Medicare Patients Receiving Long-term Dialysis. JAMA network open. 2021;4(11):e2135379-e2135379.
19. Meherali S, Punjani N, Louie-Poon S, et al. Mental health of children and adolescents amidst COVID-19 and past pandemics: a rapid systematic review. International journal of environmental research public health. 2021;18(7):3432.
20. Ozamiz-Etxebarria N, Dosil-Santamaria M, Picaza-Gorrochategui M, Idoiaga-Mondragon N. Stress, anxiety, and depression levels in the initial stage of the COVID-19 outbreak in a population sample in the northern Spain. Cadernos de saude publica. 2020;36.
21. Al Naamani Z, Gormley K, Noble H, Santin O, Al Maqbali M. Fatigue, anxiety, depression and sleep quality in patients undergoing haemodialysis. BMC nephrology. 2021;22(1):1-8.
22. Bartoszek A, Walkowiak D, Bartoszek A, Kardas G. Mental well-being (depression, loneliness, insomnia, daily life fatigue) during COVID-19 related home-confinement—A study from Poland. International journal of environmental research public health. 2020;17(20):7417.
23. Su K, Ma Y, Wang Y, et al. How we mitigated and contained the COVID-19 outbreak in a hemodialysis center: Lessons and experience. Infection Control Hospital Epidemiology. 2020;41(10):1240-1242.
24. Cantekin I, Kavurmacı M, Tan M. An analysis of caregiver burden of patients with hemodialysis and peritoneal dialysis. Hemodialysis International. 2016;20(1):94-97.
25. Sousa H, Frontini R, Ribeiro O, et al. Caring for patients with end‐stage renal disease during COVID‐19 lockdown: What (additional) challenges to family caregivers? Scandinavian Journal of Caring Sciences. 2021.
26. Feng J, Bao L, Wang X, et al. Low expression of HIV genes in podocytes accelerates the progression of diabetic kidney disease in mice. Kidney international. 2021;99(4):914-925.
27. Acaster S, Dickerhoof R, DeBusk K, Bernard K, Strauss W, Allen LF. Qualitative and quantitative validation of the FACIT-fatigue scale in iron deficiency anemia. Health quality of life outcomes. 2015;13(1):1-10.
28. Yellen SB, Cella DF, Webster K, Blendowski C, Kaplan EJJop. Measuring fatigue and other anemia-related symptoms with the Functional Assessment of Cancer Therapy (FACT) measurement system. Journal of pain symptom management. 1997;13(2):63-74.
29. Al Maqbali M, Hughes C, Gracey J, Rankin J, Hacker E, Dunwoody L. Psychometric properties of the Arabic version of the Functional Assessment of Chronic Illnesses Therapy–Fatigue in Arabic cancer patients. Journal of Pain and Symptom Management. 2020;59(1):130-138. e132.
30. Zigmond AS, Snaith RP. The hospital anxiety and depression scale. Acta psychiatrica scandinavica. 1983;67(6):361-370.
31. Bjelland I, Dahl AA, Haug TT, Neckelmann D. The validity of the Hospital Anxiety and Depression Scale: an updated literature review. Journal of psychosomatic research. 2002;52(2):69-77.
32. Terkawi AS, Tsang S, AlKahtani GJ, et al. Development and validation of Arabic version of the Hospital Anxiety and Depression Scale. Saudi journal of anaesthesia. 2017;11(Suppl 1):S11.
33. Chen C-K, Tsai Y-C, Hsu H-J, et al. Depression and suicide risk in hemodialysis patients with chronic renal failure. Psychosomatics. 2010;51(6):528-528. e526.
34. Bonenkamp AA, Druiventak TA, van Eck van der Sluijs A, van Ittersum FJ, van Jaarsveld BC, Abrahams AC. The Impact of COVID-19 on the mental health of dialysis patients. Journal of nephrology. 2021;34(2):337-344.
35. Hou T, Zhang R, Song X, et al. Self-efficacy and fatigue among non-frontline health care workers during COVID-19 outbreak: A moderated mediation model of posttraumatic stress disorder symptoms and negative coping. PloS one. 2020;15(12):e0243884.
36. Salari N, Hosseinian-Far A, Jalali R, et al. Prevalence of stress, anxiety, depression among the general population during the COVID-19 pandemic: a systematic review and meta-analysis. Globalization health. 2020;16(1):1-11.
37. Wang C, Pan R, Wan X, et al. Immediate psychological responses and associated factors during the initial stage of the 2019 coronavirus disease (COVID-19) epidemic among the general population in China. International journal of environmental research public health. 2020;17(5):1729.
38. Wang C, Pan R, Wan X, et al. A longitudinal study on the mental health of general population during the COVID-19 epidemic in China. Brain, behavior, immunity. 2020;87:40-48.
39. Bawazier LA, Stanley I, Sianipar W, Suhardjono S. Anxiety and depression among caregivers of hemodialysis patients at the Indonesian national referral hospital. Medical Journal of Indonesia. 2018;27(4):271-278.
40. Gerogianni G, Polikandrioti M, Babatsikou F, et al. Anxiety–depression of dialysis patients and their caregivers. Medicina. 2019;55(5):168.
41. Keskin G, Engin E. The evaluation of depression, suicidal ideation and coping strategies in haemodialysis patients with renal failure. Journal of clinical nursing. 2011;20(19‐20):2721-2732.
42. Jace CE, Makridis CA. Does marriage protect mental health? Evidence from the COVID‐19 pandemic. Social Science Quarterly. 2021;102(6):2499-2515.
43. Ta VP, Gesselman AN, Perry BL, Fisher HE, Garcia JR. Stress of singlehood: Marital status, domain-specific stress, and anxiety in a national US sample. Journal of Social Clinical Psychology. 2017;36(6):461-485.
44. Dilmaç B, Karababa A, Seki T, Şimşir Z, Kurnaz MF. Examining the Relationships Between Fear of Coronavirus, State Anxiety, and Relationship Happiness Among Married Turkish Individuals During COVID-19. Journal of Family Issues. 2021:0192513X211055513.
45. Adejumo OA, Iyawe IO, Akinbodewa AA, Abolarin OS, Alli EOJGMJ. Burden, psychological well-being and quality of life of caregivers of end stage renal disease patients. 2019;53(3):190-196.
46. García‐Fernández L, Romero‐Ferreiro V, Padilla S, et al. Gender differences in emotional response to the COVID‐19 outbreak in Spain. Brain. 2021;11(1):e01934.
47. Özdin S, Bayrak Özdin Ş. Levels and predictors of anxiety, depression and health anxiety during COVID-19 pandemic in Turkish society: The importance of gender. International Journal of Social Psychiatry. 2020;66(5):504-511.
48. Zhang W, Walkover M, Wu YY. The challenge of COVID-19 for adult men and women in the United States: disparities of psychological distress by gender and age. Public Health. 2021;198:218-222.
49. Donnelly R, Farina MP. How do state policies shape experiences of household income shocks and mental health during the COVID-19 pandemic? Social science medicine.2021;269:113557.
50. Zarrouq B, Abbas N, El Hilaly J, et al. An investigation of the association between religious coping, fatigue, anxiety and depressive symptoms during the COVID-19 pandemic in Morocco: a web-based cross-sectional survey. BMC psychiatry. 2021;21(1):1-13.
51. Zhang H. The influence of the ongoing COVID-19 pandemic on family violence in China. Journal of family violence. 2020:1-11.
52. Zoumpourlis V, Goulielmaki M, Rizos E, Baliou S, Spandidos DA. [Comment] The COVID‑19 pandemic as a scientific and social challenge in the 21st century. Molecular medicine reports. 2020;22(4):3035-3048.
53. Jahrami H, BaHammam AS, Bragazzi NL, Saif Z, Faris M, Vitiello MV. Sleep problems during the COVID-19 pandemic by population: a systematic review and meta-analysis. Journal of Clinical Sleep Medicine. 2021;17(2):299-313.
54. Kalwar HA, Kamani L. Problems faced by patients and health service utilization experiences of gastrointestinal patients during lockdown due to COVID-19 pandemic. Pakistan Journal of Medical Sciences. 2022;38(3Part-I):517.
55. Iqbal S, Iqbal A, Blair KAA, et al. Challenges faced by the patients on dialysis treatment in COVID-19 era and the possible solutions. Biomed J Sci Tech Res. 2021;36:28279-28282.
56. Sannes TS, Yeh IM, Gray TFJP-o. Caring for loved ones with cancer during the COVID‐19 pandemic: a double hit risk for social isolation and need for action. 2020.