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Post-traumatic stress symptoms in hemodialysis patients with MERS-CoV exposure
A Jin Cho1, Hong-Seock Lee2, Young-Ki Lee1
11Department of Internal Medicine, Kangnam Sacred Heart Hospital, Hallym University College of Medicine, 1, Singil-ro, Yeongdeungpo-gu, Seoul, 07441 South Korea.
Background:
Post-traumatic stress symptoms can occur in patients with medical illness. During the Middle East Respiratory Syndrome (MERS) outbreak in South Korea in 2015, some dialysis patients in three centers who were incidentally exposed to patients or medical staff with confirmed MERS-CoV infection were isolated to interrupt the spread of the infection. We aimed to investigate post-traumatic stress symptoms and risk factors among these patients.
Materials And Methods:
In total, 116 hemodialysis (HD) patients in contact with MERS-CoV-confirmed subjects were isolated using three strategies, namely, single room isolation, cohort isolation, and self-quarantine. We used the Impact of Event Scale-Revised-Korean (IES-R-K) to examine post-traumatic stress symptoms at 12 months after the isolation period.
Results:
Of the 116 HD patients, 27 were lost to follow-up. Of the 89 patients, 67 (75.3%) completed the questionnaires. Single room isolation was used on 40 (58.8%) of the patients, cohort isolation on 20 (29.4%), and self-imposed quarantine on 8 (11.8%). In total, 17.9% of participants (n = 12) reported post-traumatic stress symptoms exceeding the IES-R-K's cutoff point (≧18). Prevalence rates of IES-R-K ≧18 did not differ significantly according to isolation method. However, isolation duration was linearly associated with the IES-R-K score (standardized β coefficient - 0.272, P = 0.026). Scores in Avoidance, Emotional numbing and Dissociation subscale were higher in patients with longer isolation period.
Conclusion:
MERS was a traumatic experience for quarantined HD patients. IES-R-K scores were not significantly different by isolation methods. However, short isolation was associated with post-traumatic stress symptoms.
Insights
Middle East Respiratory Syndrome (MERS) isolation caused traumatic stress in hemodialysis patients. Shorter isolation periods were linked to fewer post-traumatic stress symptoms, regardless of the isolation method used.
Area of Science:
- Medical Science
- Infectious Disease Epidemiology
- Psychiatry
Background:
- Post-traumatic stress symptoms (PTSS) can manifest in patients with underlying medical conditions.
- During the 2015 MERS outbreak in South Korea, hemodialysis (HD) patients exposed to MERS-CoV were isolated to prevent transmission.
- This study investigated PTSS and associated risk factors in isolated HD patients.
Purpose of the Study:
- To assess the prevalence of post-traumatic stress symptoms in hemodialysis patients quarantined during the MERS outbreak.
- To identify risk factors, including isolation methods and duration, associated with PTSS in this cohort.
- To understand the long-term psychological impact of infectious disease outbreaks on vulnerable patient populations.
Main Methods:
- 116 hemodialysis patients exposed to MERS-CoV were isolated via single room, cohort, or self-quarantine.
- The Impact of Event Scale-Revised-Korean (IES-R-K) was administered 12 months post-isolation to assess PTSS.
- Statistical analysis examined the relationship between isolation strategies, duration, and PTSS scores.
Main Results:
- Of 89 patients completing questionnaires, 17.9% reported PTSS above the IES-R-K cutoff score (≥18).
- No significant difference in PTSS prevalence was found across different isolation methods (single room, cohort, self-quarantine).
- Isolation duration showed a linear association with IES-R-K scores (β = -0.272, P = 0.026), with longer isolation linked to higher scores, particularly in avoidance and emotional numbing subscales.
Conclusions:
- MERS quarantine represented a traumatic experience for hemodialysis patients.
- Isolation method did not significantly influence PTSS levels.
- Shorter isolation duration was associated with reduced post-traumatic stress symptoms, highlighting the importance of minimizing quarantine length.
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