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COVID-19 Outbreak and Management Approach for Families with Children on Long-Term Kidney Replacement Therapy
Rui Zhao1, Qing Zhou1, Xiao-Wen Wang2
1Department of Nephrology, Children's Hospital of Fudan University, Shanghai, China.
Insights
The coronavirus disease 2019 outbreak caused significant challenges for families with children on long-term kidney replacement therapy (KRT), leading to worries and mental distress. Interventions were provided, and no treatment interruptions were reported.
Area of Science:
- Pediatric Nephrology
- Public Health
- Psychology
Background:
- The coronavirus disease 2019 (COVID-19) pandemic presented unique challenges for managing pediatric patients requiring long-term kidney replacement therapy (KRT).
- Families of these children faced unprecedented difficulties in accessing care and managing treatment logistics during the outbreak.
- Understanding these challenges and their psychological impact was crucial for ensuring continuity of care.
Purpose of the Study:
- To identify current difficulties and future worries of families with children on long-term KRT during the COVID-19 outbreak.
- To assess the mental distress, including depressive symptoms and anxiety, experienced by these caregivers.
- To propose management strategies to guarantee uninterrupted KRT for pediatric patients.
Main Methods:
- A multicenter online survey was conducted from February 10-15, 2020, involving primary caregivers of children on long-term KRT in China.
- The survey collected demographic data, COVID-19 infection status, current difficulties, and future worries using a self-developed questionnaire.
- Validated scales (PHQ-9, GAD-7) were used to screen for depressive symptoms and anxiety.
Main Results:
- Of 220 families, 113 (51%) had children on dialysis and 107 (49%) had kidney transplants; no COVID-19 cases were reported.
- 61% of caregivers reported current difficulties (e.g., dialysis supply shortage, blood test access), and 79% had worries about the next two months.
- 13% of caregivers screened positive for depressive symptoms, and 11% for anxiety.
Conclusions:
- The COVID-19 outbreak imposed significant physical, mental, logistical, and financial burdens on families with children on long-term KRT.
- Targeted online and offline interventions were implemented to address identified caregiver needs.
- Crucially, no treatment interruptions for pediatric KRT patients were reported post-intervention.
Background And Objectives:
During the coronavirus disease 2019 outbreak, the treatment of families with children on long-term KRT is challenging. This study was conducted to identify the current difficulties, worries regarding the next 2 months, and mental distress experienced by families with children on long-term KRT during the coronavirus disease 2019 outbreak and to deliver possible management approaches to ensure uninterrupted treatment for children on long-term KRT.
Design, Setting, Participants, & Measurements:
A multicenter online survey was conducted between February 10 and 15, 2020, among the families with children on long-term KRT from five major pediatric dialysis centers in mainland China. The primary caregivers of children currently on long-term KRT were eligible and included. Demographic information, severe acute respiratory syndrome coronavirus 2 infection status, current difficulties, and worries regarding the next 2 months were surveyed using a self-developed questionnaire. The Patient Health Questionnaire-9 and the General Anxiety Disorder Scale-7 were used to screen for depressive symptoms and anxiety, respectively.
Results:
Among the children in the 220 families included in data analysis, 113 (51%) children were on dialysis, and the other 107 (49%) had kidney transplants. No families reported confirmed or suspected cases of coronavirus disease 2019. Overall, 135 (61%) and 173 (79%) caregivers reported having difficulties now and having worries regarding the next 2 months, respectively. Dialysis supply shortage (dialysis group) and hard to have blood tests (kidney transplantation group) were most commonly reported. A total of 29 (13%) caregivers had depressive symptoms, and 24 (11%) had anxiety. After the survey, we offered online and offline interventions to address their problems. At the time of the submission of this paper, no treatment interruption had been reported.
Conclusions:
The coronavirus disease 2019 outbreak has had physical, mental, logistical, and financial effects on families with children on long-term KRT.
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