Patients with end-stage renal disease treated with dialysis have poor quality of life (QOL). Improving QOL in these patients with multiple comorbidities is a large challenge. We performed a cross-sectional study to evaluate the prevalence and associated factors of depression and sleep disorders in this population. Our primary aim was to evaluate QOL measures in dialysis patients in Qatar through a series of validated questionnaires mainly concerning depression and sleep disorders. Our secondary aim was to study the associations of age, sex, and comorbid conditions with the QOL measures. We hypothesized that end-stage renal disease (ESRD) patients on dialysis would have disturbed QOL due to both ESRD and dialysis and comorbidities. This prospective cross-sectional study included adult ESRD patients receiving either hemodialysis (HD) or peritoneal dialysis (PD) in the main tertiary dialysis unit in Qatar. We administered two surveys to evaluate depression (the Center for Epidemiologic Studies Depression Scale, http://www.bmedreport.com/archives/7139) and sleep disorders (the Pittsburgh Sleep Quality Index, https://www.sleep.pitt.edu/instruments/). We also reviewed patient demographics, comorbidities, and laboratory test results to evaluate any associated factors. We randomly studied 253 patients (62% on HD and 38% on PD). Overall, 48% of patients had depression, while 83.8% had sleep disorders. The PD had more poor sleepers than the HD group (89.1% versus (vs.) 75%, p = 0.003 ). Most of our dialysis patients had poor sleep, but it was more significant in the elderly group 109 (90%) than in the young group 103 (78%) ( p = 0.009 ). Patients with diabetes mellitus (DM) had significantly more prevalence of poor sleep (131 (88.5%)) than those without DM (81 (77.1%), p = 0.01 ). More female patients had depression than male patients (52% vs. 25%, p < 0.0001 ; odds ratio: 3.27 (95% confidence interval: 1.9–5.6), p < 0.0001 ). This is the first study in Qatar to evaluate depression and sleep disorders in patients on dialysis therapy.

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Background: Hamad Medical Corporation (HMC) is providing dialysis treatment to approximately 1050 patients. COVID-19 started from China in December 2019, and the first case in Qatar was confirmed on 27th February 2020. There were challenges to provide dialysis treatment for COVID-19 positive and negative patients during the pandemic due to severe staff shortage, staff fear and psychological distress, workload, lack of dialysis slots, prolonged working hours and staff fatigue. Some staff were even deployed to COVID-19 facilities (modular dialysis services, hotel and quarantine facilities) to provide treatment. Methods: 1) A COVID-19 management committee was established 2) An on-call team was assigned to manage new cases and review dialysis slots availability. 3) Staff performance and adherence to safety measures was monitored. 4) A hierarchy model was implemented for COVID-19. A) Elimination:  – Confirmed COVID-19 patients were not to receive dialysis at Ambulatory Dialysis centres.  – Unit meetings were only held online. B) Substitution:    – Dialysis services were to be provided in HMC dialysis facilities, COVID-19 hospitals, and isolation/quarantine facilities (home/hotels). – Administrators with chronic disease worked from home. C) Engineering: – Reduce number of chairs in tearoom and waiting area – Rearrange offices, working spaces, and conference room to keep everyone 2 meters apart. D) Administrative:   – Staff, patient and family education   – Screening by using visual triaging scale   – Deployment of staff   – Managing staff mental health and psychosocial well-being Results: 76 dialysis patients and 30 dialysis staff were infected. 900 hemodialysis sessions were provided inside quarantine and isolation facilities (home, hotel, Bu-Sidra, and other locations) and Hazm Mebaireek General Hospital (HMGH) Modular Dialysis Unit from March to October 2020 . The number of COVID-19 positive patients reduced from 39 in May 2020 to 12 in July 2020 (p = 0002). Conclusion: Thanks to our approach, we were able to provide a high quality and safe dialysis service for in-centre dialysis and in COVID-19 facilities and quarantine centres (home/hotels).

Background Patients with (ESKD) undergoing dialysis, experience large burden of the disease and suffer variable symptoms that impact their health-related quality of life (HRQL). However, their symptoms are often under-recognized and under treated by their health care providers because they depend on objective measures such as physical examination and lab results. These examinations mostly don't reflect patients’ symptoms and the impact on health-related quality of life. Therefore, standardized subjective measures are important for symptoms screening and may improve symptom detection and treatment. Patient-Reported Outcome Measures (PROMs) are example of these measures and it capture patients’ symptom burden, level of functioning, and HRQL. PROMs can be used to evaluate and monitor aspects of patients’ health that may otherwise be overlooked, inform care planning, and facilitate the introduction of treatments. Aims To capture patients perceptions of their health and to address the HRQL symptoms in haemodialysis,to capture patients perception of their health and address the HRQL symptoms in chronic haemodialysis patients. To find the tools for follow up those HRQL symptoms. To encourage and promote patients patriation in care plan. Method Sample of 94 haemodialysis patients were included. We used two validated questionnaires to assess patients reported outcome (IPOS & EQ-5D) because there is no single instrument has established itself as the gold standard for measuring patient status. The (IPOS) captures symptoms such as, diarrhea, changes in skin color, restlessness, difficulty to sleep,itching,poor mobility, drowsiness, mouth sore, constipation, poor appetite,vomiting,nausea,weakness and renal scale. The (EQ-5D) is a standardized measure of health-related quality of life from five dimensions (Mobility, self-care, usual activities, pain, depression and anxiety). Results Majority of participants in this survey were male (n = 56; 60%). Middle eastern (67%), between the age of 19 to 77 (Mean = 53; STD =14). In the IPOS 50% of the patients reported the presence of symptoms such as difficulty of sleeping, itching, poor mobility, and general weakness. However, the severity of these symptoms varied from zero severity to overwhelming, 16% of patients were bothered by severe difficulties to sleep and poor mobility,15% had severe lack of energy,13% severe shortness of breath and 11% reported poor appetite. Pain was reported by 44% of patients out of which 33% expressed it as slight to moderate and 11% reported severe pain. The EQ-5D revealed that 47% have problem in walking, 41% of patients found to have difficulties in performing their usual activities, 27% of patients expressed feelings of depression and anxiety (22% mild to moderate and 5% severe).In addition 17% reported difficulties to perform self-care activities such as washing and dressing themselves. Conclusion Patients reported outcome is an important approach that captures patients’ perspectives of health and disease. PROM could result in improvement of health care delivery because it is a way to evaluate health care interventions effectiveness in a reliable and acceptable way that value patient's feedback. clinicians can utilize treatment aids to manage symptoms. Treatment aids are actionable assessment and treatment resources developed by expert clinicians and patient partners for the management of certain symptoms using these aids will help in tailoring patients therapy to improve outcome. And patients physician communication and improve quality performance.