Covid-19 Salgını Sırasında Böbrek Replasman Tedavisi Alan Hastaların Kaygı Ve Depresyon Düzeyleri

Abstract

Giriş: Son dönem böbrek yetmezliği (SDBY) olan ve renal replasman tedavisi (RRT) alan hastalarda depresyon ve anksiyete yaygın psikolojik komplikasyonlardır. COVID-19 pandemisi, bu hastaların yaşadığı psikolojik sıkıntıyı daha da artırmıştır. Bu çalışmanın amacı, COVID-19 salgını sırasında RRT alan hastaların anksiyete ve depresyon düzeylerini değerlendirmek ve bu psikolojik sonuçlarla ilişkili risk faktörlerini belirlemektir. Gereç ve Yöntem: Tanımlayıcı nitelikteki bu çalışmaya, en az altı aydır periton diyalizi veya hemodiyaliz tedavisi gören yetişkin hastalar dahil edilmiştir. Anksiyete ve depresyon düzeyleri, Hastane Anksiyete ve Depresyon Ölçeği (HAD) kullanılarak değerlendirilmiştir. Demografik ve klinik veriler de toplanarak analiz edilmiştir. Bulgular: Çalışmaya toplam 150 hasta katılmıştır (ortalama yaş: 54,3 ± 14,6 yıl); katılımcıların %60,7’si erkek, %70,7’si evlidir. Ortalama HAD anksiyete skoru 8,9 ± 4,3; depresyon skoru ise 7,9 ± 4,2 olarak bulunmuştur. Hastaların %44,7’sinde anksiyete, %38,7’sinde ise depresyon saptanmıştır. Çok değişkenli analizde; kadın cinsiyet, düşük eğitim düzeyi ve eşlik eden hastalıklar, daha yüksek anksiyete ve depresyon düzeyleriyle anlamlı şekilde ilişkili bulunmuştur. Tartışma: COVID-19 pandemisi sırasında RRT alan hastalarda anksiyete ve depresyon yaygındır. Kadın cinsiyet, düşük eğitim seviyesi ve komorbiditeler bu psikolojik durumlar için önemli risk faktörleri olarak öne çıkmaktadır. Sağlık çalışanları bu risk faktörlerinin farkında olmalı ve SDBY hastalarının ruh sağlığını desteklemek için uygun müdahalelerde bulunmalıdır.

Keywords

• covid-19
• depresyon
• hemodiyaliz
• periton diyalizi

Supporting Institution

Bu araştırma kamu, ticari veya kâr amacı gütmeyen sektörlerdeki fon sağlayıcı kuruluşlardan herhangi bir özel hibe almamıştır.

Ethical Statement

Çalışmaya Süleyman Demirel Üniversitesi Tıp Fakültesi Etik Kurulu’nun 2012-KAEK-38 sayılı (no:72867572.050.01.04-57401, tarih: 30.04.2020) onayı alınmıştır.

Anxiety And Depression Level Of Patients Receiving Renal Replacement Therapy During The Covid-19 Outbreak

Abstract

Introduction: Depression and anxiety are common psychological complications in patients with end-stage renal disease (ESRD) receiving renal replacement therapy (RRT). The COVID-19 pandemic has further exacerbated the psychological distress experienced by these patients. This study aimed to investigate the anxiety and depression levels of patients receiving RRT during the COVID-19 outbreak and to identify the factors associated with these psychological outcomes. Materials and Methods: This descriptive study was conducted among adult patients who were received peritoneal dialysis or hemodialysis treatment for at least 6 months. The Hospital Anxiety and Depression Scale (HADS) was used to assess anxiety and depression levels. Demographic and clinical data were also collected. Results: A total of 150 patients participated in the study, with a mean age of 54.3 ± 14.6 years. The majority of patients were male (60.7%) and married (70.7%). The mean HADS anxiety score was 8.9± 4.3, and the mean HADS depression score was 7.9±4.2. The prevalence of anxiety and depression was 44.7% and 38.7%, respectively. Multivariate analysis revealed that female gender, lower education level, and comorbidities were significantly associated with higher anxiety and depression levels. Discussion: The study findings suggest that anxiety and depression are prevalent among patients receiving RRT during the COVID-19 outbreak. Female gender, lower education level, and comorbidities were identified as risk factors for these psychological outcomes. Healthcare providers should be aware of these risk factors and provide appropriate support and interventions to improve the mental well-being of patients with ESRD receiving RRT during the COVID-19 pandemic.

Keywords

• COVID-19
• Depression
• Hemodialysis
• Peritoneal dialysis

Supporting Institution

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

Ethical Statement

Approval for the study was granted by the Süleyman Demirel University Faculty of Medicine Ethics Committee (2012-KAEK-38) (no:72867572.050.01.04-57401, dated: 30.04.2020).

References

1. 1. Süleymanlar G, Ateş K, Seyahi N. Türkiye'de Nefroloji, Diyaliz ve Transplantasyon. T.C. Sağlık Bakanlığı ve Türk Nefroloji Derneği Ortak Raporu 2018, Miki Matbaacılık San. Tic. Ltd. Şti. Ankara, 2019. ISBN 978-605-62465-0-0
2. 2. Saeed Z, Ahmad AM, Shakoor A, Ghafoor F, Kanwal S. Depression in patients on hemodialysis and their caregivers. Saudi J Kidney Dis Transpl. 2012;23(5):946-52.
3. 3. Esen B, Gökmen SE, Atay AE, et al. Evaluation of the Frequency and Related Factors of Depression and Anxiety in Patients with End Stage Renal Disease Receiving Renal Replacement Therapies. Turk Neph Dial Transpl. 2015; 24 (3): 270-77.
4. 4. De Sousa A. Psychiatric issues in renal failure and dialysis. Indian J Nephrol 2008;18:47-50.
5. 5. Cukor D, Cohen SD, Peterson RA, Kimmel PL. Psychosocial aspects of chronic disease: ESRD as a paradigmatic illness. J Am Soc Nephrol. 2007;18:3042-55.
6. 6. Daugirdas JT, Blake PG, Ing TS. Diyaliz El Kitabı. Bozfakıoğlu S (Çeviren). 5. Baskı, Ankara: Güneş Tıp Kitabevi, 2020; p. 528-34.
7. 7. Shirazian S, Grant CD, Aina O, Mattana J, Khorassani F, Ricardo AC. Depression in Chronic Kidney Disease and End-Stage Renal Disease: Similarities and Differences in Diagnosis, Epidemiology, and Management. Kidney Int Rep. 2016;20;2(1):94-107.
8. 8. Zhou P, Yang XL, Wang XG, et. All. pneumonia outbreak associated with a new coronavirus of probable bat origin. Nature. 2020;579(7798):270-273.

9. 9. COVID-19 Case Tracker. Johns Hopkins University and Medicine Coronavirus Resource Center. https://coronavirus.jhu.edu/. Accessed April 16, 2020.
10. 10. World Health Organization Statement on the second meeting of the International Health Regulations (2005) Emergency Committee regarding the outbreak of novel coronavirus (2019-nCoV). Published January 30, 2020.
11. 11. Mak IW, Chu CM, Pan PC, Yiu MG, Chan VL. Long-term psychiatric morbidities among SARS survivors. Gen Hosp Psychiatry. 2009;31(4):318-26.
12. 12. Brooks S, Amlôt R, Rubin GJ, Greenberg N. Psychological resilience and post-traumatic growth in disaster-exposed organisations: overview of the literature. BMJ Mil Health 2020; 166: 52-6.
13. 13. Li S, Wang Y, Xue j, Zhao N, Zhu T. The impact of COVID-19 Epidemic Declaration on Psychological Consequences: A study on Active Weibo Users. Int. J Environ Res Public Health. 2020; 19; 17 (6):2032.
14. 14. Lovibond, P. F., Lovibond, S. H. The structure of negative emotional states: Comparison of the Depression Anxiety Stress Scales (DASS) with the Beck Depression and Anxiety Inventories. Behaviour research and therapy, 1995;33(3), 335-43.
15. 15. Henry, J. D., Crawford, J. R. The short‐form version of the Depression Anxiety Stress Scales (DASS‐21): Construct validity and normative data in a large non‐clinical sample. British Journal of Clinical Psychology, 2005;44(2), 227-39.
16. 16. Yılmaz Ö, Boz H, Arslan A. The Validity and reliability of Depression Stress and Anxiety Scale (DASS 21) Turkish Short Form. Journal of Finance Economics and Social Studies 2017;2(2);78-91.
17. 17. Creamer M, Bell R, Failla S. Psychometric properties of the Impact of Event Scale-Revised. Behav Res Ther. 2003;41:14891496.
18. 18. Çorapçioğlu A, Yargiç İ, Geyran P, Kocabaşoğlu N. The validity and reliability of the Turkish version of the "Impact of Events Scale" (IES-R)." New/Yeni Symposium: psikiyatri, nöroloji ve davraniş bilimleri dergisi, 2006;44(1),14-22.
19. 19. Barutçu-Ataş D, Arıkan H, Alışır-Ecder S, Çiftçi H. Comparison of Anxiety, Depression and the Quality of Life Between Hemodialysis and Renal Transplantation Patients. Turk Neph Dial Transpl 2017; 26 (2): 171-17
20. 20. Berber, T. Disease Perception and Personality Characteristics in Patients Receiving Hemodialysis Treatment. Halic University, Master's Thesis, İstanbul, 2014.
21. 21. Afsar B. The relation between Internet and social media use and the demographic and clinical parameters, quality of life, depression, cognitive function and sleep quality in hemodialysis patients: Social media and hemodialysis. Gen Hosp Psychiatry 2013;35(6):625-30.
22. 22. Balaban Ö D, Aydın E, Keyvan A, Yazar MS, Tuna Ö, Özgüven H D. Psychiatric Comorbidity, Sexual Dysfunction, and Quality of Life in Patients Undergoing Hemodialysis: A Case-Control Study. Noro Psikiyatr Ars. 2017; 54(2): 137–42.
23. 23. Sağduyu A, Sentürk V, Sezer S, Emiroğlu R, Ozel S. Psychiatric problems, life quality and compliance in patients treated with haemodialysis and renal transplantation. Turkish Journal of Psychiatry. 2006; 17:22-31.
24. 24. Hedayati SS, Minhajuddin AT, Toto RD, Morris DW, Rush AJ. Prevalence of major depressive episode in CKD. Am J Kidney Dis 2009; 54:424-32.
25. 25. Dane E, Olgun N. Psychological Resilience States of Hemodialysis Patients and Evaluation of Affecting Factors. Nefroloji Hemşireliği Dergisi 2016. (1):43-59.
26. 26. Sezer S, Uyar ME, Bal Z, Tutal E, Ozdemir Acar FN. The influence of socioeconomic factors on depression in maintenance hemodialysis patients and their caregivers. Clin Nephrol 2013;80(5):342-48.
27. 27. Şentürk A, Levent BA, Tamam L. The Psychopathology in Patients with Chronic Renal Failure Treated with Hemodialysis. Journal of Experimental and Clinical Medicine. 2000;17(3):163-72.
28. 28. Naves-Díaz M, Passlick-Deetjen J, Guinsburg A, et al. Calcium, phosphorus, PTH and death rates in a large sample of dialysis patients from Latin America. The CORES Study. Nephrol Dial Transplant 201;26:1938-47.