The Quality of Life, Depression Levels and Coping Styles of Patients on Kidney Transplant Waiting List

Mediating Role of Viral Anxiety and Insomnia in Relationship Between Work-Related Stress and Depression Among Cold Chain Workers During COVID-19 Pandemic

BACKGROUND

Here we investigated whether cold chain workers' insomnia, work-related stress, and viral anxiety contributed to their depression. Furthermore, we investigated the role of viral anxiety in mediating the association between work-related stress and depressive symptoms.

METHODS

All 200 invited cold chain workers voluntarily responded to an online survey. All were working at a market in Taiyuan, Shanxi Province, China, and responsible for testing nucleic acids in imported cold chain foods and disinfecting outer packaging at government request. We collected their demographic variables and rated their symptoms using the Stress and Anxiety to Viral Epidemics-6 Items (SAVE-6), Patient Health Questionnaire-9, Insomnia Severity Index (ISI), Perceived Stress Scale (PSS), and Maslach Burnout Inventory - General Survey (MBI-GS).

RESULTS

Cold chain workers' depression was significantly correlated with higher SAVE-6 (r = 0.450, P < 0.01), ISI (r = 0.603, P < 0.01), MBI-GS (r = 0.481, P < 0.01), and PSS (r = 0.390, P < 0.01) scores. SAVE-6 score was significantly correlated with ISI (r = 0.462, P < 0.01), MBI-GS (r = 0.305, P < 0.01), and PSS (r = 0.268, P < 0.01) scores. Linear regression revealed that their depression was predicted by SAVE-6 (β = 0.183, P = 0.003), ISI (β = 0.409, P < 0.001), and MBI-GS (β = 0.236, P = 0.002, adjusted R² = 0.440, F = 40.04, P < 0.001) scores. Mediation analysis showed that their burnout directly influenced their depression, while viral anxiety or insomnia severity mediated the influence of burnout on depression.

CONCLUSION

The study showed that burnout was a direct cause of depression and that viral anxiety and insomnia severity mediated the relationship between burnout and depression.

Coping Behaviors and Incident Kidney Disease

Key Points

Adaptive coping behaviors are associated with lower odds of incident CKD. Coping behaviors could represent a target to prevent CKD.

Background

How someone copes may alter the trajectory of their kidney function. We aimed to evaluate whether coping behaviors were associated with incident CKD or rapid kidney function decline.

Methods

We used data from the Healthy Aging in Neighborhoods of Diversity across the Life Span study (Baltimore, MD) for this longitudinal analysis. Adaptive and maladaptive coping behavioral constructs were measured using the Brief COPE Inventory at visit 1. We used multiple logistic regression to assess the odds of incident CKD and rapid kidney function decline per point increase in coping scales and adjusted for baseline demographics and clinical variables.

Results

Of 1935 participants, mean age was 48 years, 44% were male, 56% were Black persons, and baseline mean (SD) eGFR was 91 (16) ml/min per 1.73 m2. After a median of 8.2 years, 113 participants developed incident CKD and 341 had rapid kidney function decline. Compared with those who reported they usually did not use adaptive coping behaviors at all (such as emotional support), those with the highest use of adaptive coping had lower odds of incident CKD. Every 1-unit increase in adaptive coping corresponded with a 2% lower adjusted odds of incident CKD (odds ratio, 0.98; 95% confidence interval, 0.95 to 0.99). There was no association between maladaptive coping behaviors and incident CKD. Coping behaviors were not associated with rapid kidney function decline.

Conclusions

Adaptive coping behaviors were associated with lower odds of incident CKD and could represent a target to facilitate CKD prevention. The role of medical care in this association is an area worthy of further investigation.

Fear of COVID-19, stress and depression: A meta-analytic test of the mediating role of anxiety

OBJECTIVES

The COVID-19 pandemic has negatively affected the lives of millions of individuals physiologically, behaviorally, socially, and/or psychologically. Moreover, there is now much empirical evidence that mental health problems have increased during the pandemic period and these problems have various consequences. The changes in the mood states of individuals due to the pandemic underpins the rationale of the present study. The aim of the study was to identify the cross-sectional associations between fear of COVID-19, stress, anxiety, and depression by using two stage-meta-analytic structural equation modeling (TS-MASEM).

DESIGN

This is a meta-analytic structural equation modelling study.

METHOD

A systematic literature review initially identified 4840 studies. As a result of applying inclusion and exclusion criteria, 25 studies comprising 28 samples (reporting 120 effect sizes) were eligible for inclusion in the current TS-MASEM (N = 16,452).

RESULTS

The results showed significant associations between fear of COVID-19, stress, anxiety, and depression. Additionally, the mediation role of anxiety in the association between depression and fear of COVID-19 and stress was explored.

CONCLUSIONS

Although the results did not allow for causal inferences regarding depression, they provide insight into the possible consequences of fear of COVID-19 and comorbid problems for clinicians and researchers.

Stressors and Information-Seeking by Dialysis and Transplant Patients During COVID-19 Reported on a Telephone Hotline: A Mixed Methods Study

Rationale & Objective

In early 2020, we activated a telephone hotline, the coronavirus disease 2019 (COVID-19) Kidney or Transplant Listening and Resource Center, to learn more about the impact of the COVID-19 pandemic on the stress and information-seeking behaviors of dialysis and transplant patients.

Study Design

A mixed-methods study including semi-structured, qualitative interviews probing about emotional, health, and financial challenges experienced and quantitative surveys assessing depression and anxiety levels and information-seeking behaviors.

Setting & Participants

99 participants (28 dialysis patients; 71 transplant patients), varying by race and ethnicity (Hispanic, 25.3%; White, 23.2%; Asian, 24.2%; Black, 24.2%), shared their COVID-19 pandemic experiences and information-seeking behaviors by telephone. Interviews and surveys were conducted from June 17, 2020, to November 24, 2020.

Analytical Approach

Qualitative themes were identified using thematic analysis. Frequencies were calculated to assess levels of depression and anxiety using the Patient Health Questionnaire for Depression and Anxiety and types of information-seeking behaviors.

Results

7 themes and 16 subthemes emerged. Themes of commonly reported stressors include postponing medical visits; decreased accessibility of getting medication; difficulty in receiving up-to-date, patient-focused health information and dialysis supplies; and delays in medical appointments. Other stressors include losses of health insurance and income, and increased vigilance in behaviors to avoid contracting COVID-19. 15 participants had moderate to severe anxiety and depression symptoms and reported more frequent and severe panic attacks after the COVID-19 pandemic. Participants sought emotional support from family, friends, and faith communities. They also commonly obtained information from news media and reported needing more transplant-specific updates about COVID-19, and frequent communication from their kidney and transplant specialists.

Limitations

This convenience sample of individuals willing to share their experiences through a telephone hotline may not generalize to all dialysis and transplant patients; stressors related to the COVID-19 pandemic for these patients continue to change.

Conclusions

As the impact of the pandemic continues, needs-based interventions tailored for the kidney and transplant community, including access to mental health resources, education, and support for care transitions, should continue.