Evolution of the psychological repercussions of the COVID-19 pandemic on hemodialysis patients and caregivers between April 2020 and April 2022

Introduction: The health crisis linked to the COVID-19 pandemic and the changes in practices it imposed in dialysis centers were accompanied by observable psychological repercussions for both patients and caregivers. Our aim was to assess the evolution of these repercussions in these two populations, to identify the coping strategies used, and to study the association between psychological symptoms and coping strategies.

Methods: This multi-center, French, non-interventional study was conducted in two phases (T1 : April 2020 and T2 : April 2022) in 13 volunteer dialysis facilities. Pseudonymized questionnaires were used to collect sociodemographic data, self-reported psychological history, and, at both study times, stress levels (simple numerical stress scales), anxiety and depressive symptomatology (Hospital Anxiety and Depression Scale), and coping strategies (Brief COPE). Factors associated with anxiety and depression were studied with a multivariable logistic regression model.

Results: 177 patients and 99 caregivers participated in both phases of the study. In each population, stress and anxiety scores decreased significantly between T1 and T2 (p<0.001), while depression scores remained stable. The most frequently used coping strategy was the use of positive thoughts and was associated with lower anxiety and depression symptoms. By contrast, the avoidance strategy was associated with more anxiety-depressive symptoms.

Conclusion: By April 2022, in France, hemodialysis caregivers' and patients' health crisis-related stress and anxiety levels had decreased compared with April 2020. Positive thinking coping strategies should be promoted among patients and caregivers because they have been shown to protect mood.