Feasibility of infection control measures in hemodialysis units to prevent outbreaks of COVID-19: A descriptive study from quebec

Background: Dialysis patients are at high risk for severe complications related to COVID-19. The present study examined perception of risk of COVID-19 and its impact on behavior modification and emotional well-being among in-center hemodialysis (ICHD) patients during the recent COVID-19 pandemic. Methods: In-depth, semi-structured telephone interviews were conducted between May and July 2020 with adult ICHD patients dialyzing at a large dialysis organization (LDO). Responses were analyzed using inductive thematic analysis. The reliability of categories was examined by an independent coder. Results: A total of 41 LDO patients were interviewed. The median age was 63 years and 54% were female. Satisfactory inter-rater reliability was achieved for all identified themes (kappa = 0.70 -0.99). We found that the COVID-19 pandemic caused a high level of worry among ICHD study subjects;78% of those interviewed felt that they are at high risk of COVID-19. Consequently, subjects reported a high level of compliance with appropriate protective behaviors during the pandemic, such as wearing a mask, sheltering at home, social distancing, and frequent handwashing. The perception of the actual likelihood of contracting the virus during a hemodialysis session was relatively low (M = 3.38 on a 0 to 10 risk scale). The pandemic had no impact on self-reported adherence to dialysis treatment schedules, medications, or diet. However, subjects reported dominating emotions of frustration, fear, stress, depression, and anxiety. Conclusions: The study subjects were aware of the risk of COVID-19 and seemingly increased compliance with protective behaviors as a consequence. It appears that the pandemic had a strong negative impact on the study subjects' emotional well-being and that additional support in this area might be beneficial.