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Laughlin LM, Noyes J, Neukirchinger B, Williams D, Phillips R, Griffin S. "It was classed as a nonemergency": Women's experiences of kidney disease and preconception decision-making, family planning, and parenting in the United Kingdom during COVID-19. PERSPECTIVES ON SEXUAL AND REPRODUCTIVE HEALTH 2024; 56:147-157. [PMID: 38485661 DOI: 10.1111/psrh.12256] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/21/2024]
Abstract
OBJECTIVES To investigate the experiences of women with kidney disease, residing in the United Kingdom (UK), living through the first 18 months of the COVID-19 pandemic with specific focus on preconception decision-making, family planning, and parenting. METHODS We conducted a mixed-methods study, comprising an online survey and follow-up interviews, with UK-resident women aged 18-50. RESULTS We received 431 surveys and conducted 30 interviews. Half (n = 221, 51%) of the survey respondents considered that COVID-19 influenced the quality of communication with healthcare professionals and 68% (n = 295) felt that the pandemic disrupted their support networks. Interview participants indicated that delayed and canceled appointments caused anxiety, grief, and loss of pregnancy options. Women's perception of themselves as (good) mothers as well as their capacity to have and raise a child, meet partners, and sustain healthy relationships was negatively affected by the "clinically extremely vulnerable" label. Women's trust in their healthcare was dismantled by miscommunication and variation in lockdown rules that caused confusion and increased worry. Women reported that COVID-19 contributed to postnatal depression, excessive concern over infant mortality, preoccupation over others following rules, and catastrophising. CONCLUSION Some women in the UK with chronic kidney disease lost or missed their opportunity to have children during the pandemic. Future pandemic planners need to look more holistically and longer term at what is and is not classed as an emergency, both in how services are reconfigured and how people with chronic conditions are identified, communicated with, and treated.
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Affiliation(s)
- Leah Mc Laughlin
- School of Medical and Health Sciences, Bangor University, Bangor, UK
| | - Jane Noyes
- School of Medical and Health Sciences, Bangor University, Bangor, UK
| | | | | | - Rhiannon Phillips
- Cardiff School of Sport and Health Sciences, Cardiff Metropolitan University, Cardiff, UK
| | - Sian Griffin
- Department of Nephrology, Cardiff and Vale University Health Board, Cardiff, UK
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Li K, Xia Y, Ye H, Sun X, Shi B, Wu J. Effectiveness and safety of immune response to SARS‑CoV‑2 vaccine in patients with chronic kidney disease and dialysis: A systematic review and meta‑analysis. Biomed Rep 2024; 20:78. [PMID: 38590946 PMCID: PMC10999903 DOI: 10.3892/br.2024.1766] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Accepted: 02/02/2024] [Indexed: 04/10/2024] Open
Abstract
The coronavirus disease 2019 (COVID-19) vaccination is the most effective way to prevent COVID-19. However, for chronic kidney disease patients on long-term dialysis, there is a lack of evidence regarding the efficacy and safety of the immune response to the vaccine. The present meta-analysis explores the efficacy and safety of COVID-19 vaccine in the immune response of patients with chronic kidney disease (CKD) undergoing dialysis. PubMed, Web of Science, Science Direct, and Cochrane Library databases were systematically searched from January 1, 2020, to December 31, 2022. Data analysis was performed using REVMAN 5.1s and Stata14 software. Baseline data and endpoint events were extracted, mainly including age, sex, dialysis vintage, body mass index (BMI), vaccine type and dose, history of COVID-19 infection, seropositivity rate, antibody titer, pain at injection site, headache and other safety events. The meta-analysis included 33 trials involving 81,348 patients. The immune efficacy of patients with CKD and dialysis was 80% (95 CI, 73-87%). The seropositivity rate of individuals without COVID-19 infection was 76.48% (3,824/5,000), while the seropositivity rate of individuals with COVID-19 infection was 80.82% (1,858/2,299). The standard mean difference of antibody titers in CKD and dialysis patients with or without COVID-19 infection was 27.73 (95% CI, -19.58-75.04). A total of nine studies reported the most common adverse events: Pain at the injection site, accounting for 18% (95 CI, 6-29%), followed by fatigue and headache, accounting for 8 (95 CI, 4-13%) and 6% (95 CI, 2-9%), respectively. COVID-19 vaccine benefitted patients with CKD undergoing dialysis with seropositivity rate ≥80%. Adverse events such as fatigue, headache, and pain at the injection site may occur after COVID-19 vaccination but the incidence is low.
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Affiliation(s)
- Kejia Li
- Department of Nephrology, The First People's Hospital of Jiashan, Jiaxing, Zhejiang 314100, P.R. China
| | - Yang Xia
- Department of Nephrology, The First People's Hospital of Jiashan, Jiaxing, Zhejiang 314100, P.R. China
| | - Hua Ye
- Department of Nephrology, The First People's Hospital of Jiashan, Jiaxing, Zhejiang 314100, P.R. China
| | - Xian Sun
- Department of Nephrology, The First People's Hospital of Jiashan, Jiaxing, Zhejiang 314100, P.R. China
| | - Bairu Shi
- Department of Nephrology, The First People's Hospital of Jiashan, Jiaxing, Zhejiang 314100, P.R. China
| | - Jiajun Wu
- Department of Nephrology, The First People's Hospital of Jiashan, Jiaxing, Zhejiang 314100, P.R. China
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Li Y, Hou T, Cheng M, Miao Y, Yeerjang Y, Sheng CS, Xue K, Wu C, Zhang S, Yan Q, Pei J, Yang Q, Tian J, Xu W, Shi Y. Anxiety prevalence and its association with physical activity in patients with non-communicable diseases during COVID-19 lockdown: a cross-sectional study in Shanghai, China. BMC Public Health 2023; 23:317. [PMID: 36782166 PMCID: PMC9924212 DOI: 10.1186/s12889-022-14369-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Accepted: 10/17/2022] [Indexed: 02/15/2023] Open
Abstract
BACKGROUND Quarantine due to the COVID-19 pandemic may have created great psychological stress among vulnerable populations. We aimed to investigate the prevalence of anxiety and explore the association between physical activities (PA) and anxiety risk in people with non-communicable diseases during the period of COVID-19 lockdown. METHODS We conducted a cross-sectional telephone survey from February 25 to April 20, 2020, the period of COVID-19 lockdown in Shanghai. Up to 8000 patients with type 2 diabetes and/or hypertension were selected using multi-stage cluster random sampling. PA level was measured based on the International Physical Activity Questionnaire using Metabolic Equivalent for Task scores, while symptoms of anxiety were assessed by the 7-item Generalized Anxiety Disorder scale. Multiple logistic regression analyses were performed to evaluate the associations of type and level of PA with the risk of anxiety. RESULTS Of a total 4877 eligible patients, 2602 (53.4%) reported with anxiety, and 2463 (50.5%), 123 (2.5%) and 16 (0.3%) reported with mild, moderate, and severe anxiety. The prevalence of anxiety was higher in the females, the elders, non-smokers, non-drinkers, and patients with diabetes, and the associations of anxiety with sex, age, smoking, drinking and diagnosis of diabetes were significant. A significant negative association was observed for housework activities (OR 0.53, 95%CI: [0.45, 0.63], p < 0.001) and trip activities (OR 0.55, 95%CI: [0.48, 0.63], p < 0.001) with anxiety, but no significant was found for exercise activities (OR 1.06, 95%CI: [0.94, 1.20], p = 0.321). Compared with patients with a low PA level, those with a moderate (OR 0.53, 95%CI: [0.44, 0.64], p < 0.001) or a high PA level (OR 0.51, 95%CI: [0.43, 0.51], p < 0.001) had a lower prevalence of anxiety. CONCLUSION This study demonstrates a higher prevalence of anxiety in patients with hypertension, diabetes, or both during the COVID-19 lockdown. The negative associations of housework and trip activities with anxiety highlight the potential benefit of PA among patients with non-communicable diseases.
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Affiliation(s)
- Yanyun Li
- grid.430328.eShanghai Municipal Center for Disease Control and Prevention, Shanghai, China
| | - Tianzhichao Hou
- grid.16821.3c0000 0004 0368 8293Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Minna Cheng
- grid.430328.eShanghai Municipal Center for Disease Control and Prevention, Shanghai, China
| | - Ya Miao
- grid.16821.3c0000 0004 0368 8293Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yeerzati Yeerjang
- grid.8547.e0000 0001 0125 2443Key Lab of Health Technology Assessment (National Health Commission), School of Public Health, Fudan University, Shanghai, China ,grid.8547.e0000 0001 0125 2443School of Public Health, Fudan University, Shanghai, China
| | - Chang-sheng Sheng
- grid.16821.3c0000 0004 0368 8293Center for Epidemiological Studies and Clinical Trials and Center for Vascular Evaluation, Shanghai Institute of Hypertension, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Kun Xue
- grid.8547.e0000 0001 0125 2443School of Public Health, Fudan University, Shanghai, China
| | - Cui Wu
- Center for Disease Control and Prevention of Baoshan District, Shanghai, China
| | - Sheng Zhang
- grid.430328.eShanghai Municipal Center for Disease Control and Prevention, Shanghai, China
| | - Qinghua Yan
- grid.430328.eShanghai Municipal Center for Disease Control and Prevention, Shanghai, China
| | - Jianfeng Pei
- grid.8547.e0000 0001 0125 2443Key Lab of Health Technology Assessment (National Health Commission), School of Public Health, Fudan University, Shanghai, China ,grid.8547.e0000 0001 0125 2443School of Public Health, Fudan University, Shanghai, China
| | - Qinping Yang
- grid.430328.eShanghai Municipal Center for Disease Control and Prevention, Shanghai, China
| | - Jingyan Tian
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China. .,Shanghai National Clinical Research Center for Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai Key Laboratory for Endocrine Tumor, State Key Laboratory of Medical GenomicsRuijin HospitalShanghai Jiao Tong University School of Medicine, Shanghai, 200025, China.
| | - Wanghong Xu
- Key Lab of Health Technology Assessment (National Health Commission), School of Public Health, Fudan University, Shanghai, China. .,School of Public Health, Fudan University, Shanghai, China.
| | - Yan Shi
- Shanghai Municipal Center for Disease Control and Prevention, Shanghai, China. .,National Clinical Research Center for Aging and Medicine, Shanghai, China.
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Cui Y, Li R, Yang T, Wang H, Jin S, Liu N, Liu H, Zhang Y. Influence of positive and negative affect on self-management among patients with early chronic kidney disease during the COVID-19 pandemic: The mediating and suppressing effect of ego depletion. Front Psychiatry 2022; 13:992404. [PMID: 36245863 PMCID: PMC9556950 DOI: 10.3389/fpsyt.2022.992404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Accepted: 09/13/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Self-management in patients with early chronic kidney disease (CKD) can effectively delay damage to renal function. However, with the continuous spread of COVID-19, patients cannot receive timely treatment, which can lead to different affects, resulting in ego depletion and serious challenges to self-management. This study aimed to investigate the mediating and suppressing roles of ego depletion on the relationship between positive and negative affect and self-management among patients with early CKD during the COVID-19 pandemic in China. METHODS A total of 383 patients with early CKD from three tertiary hospitals were enrolled by convenience sampling in our cross-sectional study from September 2021 to March 2022. Participants completed the Sociodemographic Questionnaire, Positive Affect and Negative Affect Scale, Self-Regulating Fatigue Scale and Chronic Kidney Disease Self-Management Instrument. A structural equation model was conducted to test the mediating and suppressing effects of ego depletion on the relationship between positive and negative affect and self-management. RESULTS The average score of the participants' self-management was 84.54 (SD: 19.72), and nearly 60% of them were at low and moderate levels. The mediating effect of positive affect on self-management through ego depletion was significant (β = 0.248, 95% CI: 0.170 to 0.376), accounting for 53.22% of the total effect. The suppressing effect of negative affect on self-management through ego depletion was significant (β = -0.191, 95% CI: -0.310 to -0.118), and the absolute value of the ratio of the suppressing effect to the direct effect was 66.55%. CONCLUSIONS Ego depletion partially mediated the relationship between positive affect and self-management while suppressing the relationship between negative affect and self-management among patients with early CKD during the COVID-19 pandemic. The reduction of patients' ego depletion must be taken as the intervention target to improve self-management and delay the progression of CKD.
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Affiliation(s)
- Yi Cui
- Department of Nursing, Air Force Medical University, Xi'an, China
| | - Rong Li
- Department of Nephrology, The First Affiliated Hospital of Air Force Medical University, Xi'an, China
| | - Tianqi Yang
- Department of Military Medical Psychology, Air Force Medical University, Xi'an, China
| | - Hua Wang
- Department of Nephrology, The Second Affiliated Hospital of Air Force Medical University, Xi'an, China
| | - Shasha Jin
- Department of Nephrology, The Second Affiliated Hospital of Air Force Medical University, Xi'an, China
| | - Na Liu
- Department of Nursing, Air Force Medical University, Xi'an, China
| | - Hongbao Liu
- Department of Nephrology, The Second Affiliated Hospital of Air Force Medical University, Xi'an, China
| | - Yinling Zhang
- Department of Nursing, Air Force Medical University, Xi'an, China
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Lv H, Meng J, Chen Y, Yang F, Wang W, Wei G, Zhang J, Wang H, Wang M, Zhou L, Liu H. Impact of COVID-19 Pandemic on Elevated Anxiety Symptoms of Maintenance Hemodialysis Patients in China: A One-Year Follow-Up Study. Front Psychiatry 2022; 13:864727. [PMID: 35664473 PMCID: PMC9160521 DOI: 10.3389/fpsyt.2022.864727] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Accepted: 04/06/2022] [Indexed: 11/13/2022] Open
Abstract
Recent studies have shown that coronavirus disease 2019 (COVID-19) aggravates anxiety in patients with maintenance hemodialysis (MHD), but it is still unclear how long this adverse effect will last. This study aims to investigate the impact of COVID-19 on the elevated anxiety symptoms of MHD patients 1 year after the outbreak. Assessment of elevated anxiety symptoms was performed on patients with MHD during early COVID-19 (February 17-February 29, 2020) and 1-year follow-up (March 1-March 13, 2021), and a total of 100 patients had completed face-to-face questionnaires at the first and 1-year follow-up. At the beginning of the outbreak, 40% of the patients with MHD had anxiety symptoms [self-rating anxiety scale (SAS) score ≥ 50], and 11% (SAS score: 60-69) and 2% (SAS score ≥ 70) of the patients had moderate and severe anxiety symptoms, respectively. Multivariate analysis shows that possibility of unaccompanied transfer, possibility of family members or themselves being infected in a hospital, added body temperature monitoring during dialysis, and increased medical procedures are the risk factors in elevated anxiety symptoms during early COVID-19. At the 1-year follow-up, the incidence of anxiety symptoms in the same group of patients declined to 28%, and all the patients had mild anxiety symptoms (SAS score: 50-59), which is significantly lower than that of the early COVID-19 pandemic with statistically significant difference (p = 0.003). Increased protective measures taken by the medical staves were the only risk factor in elevated anxiety symptoms during the 1-year follow-up. This study shows that COVID-19 has a direct impact on the deterioration of anxiety symptoms in patients with MHD. With the changes of the requirements for COVID-19 prevention and control, as well as the enhancement of propaganda and education of the pandemic and psychological care, the severity and risk factors of anxiety symptoms in the patients with MHD are changing. Thus, targeted interventions are suggested to improve the psychological endurance of the patients with MHD.
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Affiliation(s)
- Honghong Lv
- Department of Nephrology, Tangdu Hospital, The Air Force Military Medical University, Xi'an, China
| | - Junping Meng
- Department of Nephrology, Tangdu Hospital, The Air Force Military Medical University, Xi'an, China
| | - Yang Chen
- Department of Nephrology, Tangdu Hospital, The Air Force Military Medical University, Xi'an, China
| | - Feng Yang
- Department of Nephrology, Tangdu Hospital, The Air Force Military Medical University, Xi'an, China
| | - Wen Wang
- Department of Nephrology, Tangdu Hospital, The Air Force Military Medical University, Xi'an, China
| | - Guohua Wei
- Department of Nephrology, Tangdu Hospital, The Air Force Military Medical University, Xi'an, China
| | - Jiaojiao Zhang
- Department of Nephrology, Tangdu Hospital, The Air Force Military Medical University, Xi'an, China
| | - Huan Wang
- Department of Nephrology, Tangdu Hospital, The Air Force Military Medical University, Xi'an, China
| | - Mengqiu Wang
- Department of Nephrology, Tangdu Hospital, The Air Force Military Medical University, Xi'an, China
| | - Lu Zhou
- Department of Nephrology, Tangdu Hospital, The Air Force Military Medical University, Xi'an, China
| | - Hongbao Liu
- Department of Nephrology, Tangdu Hospital, The Air Force Military Medical University, Xi'an, China
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