The Associations of Suspected COVID-19 Symptoms with Anxiety and Depression as Modified by Hemodialysis Dietary Knowledge: A Multi-Dialysis Center Study

Abstract

During the COVID-19 pandemic, it is essential to evaluate hemodialysis patients’ dietary knowledge, especially among those with COVID-19 related symptoms, in order to identify appropriate strategies in managing their mental health. The study’s purposes were to test the psychometric properties of the hemodialysis dietary knowledge (HDK) scale, and to investigate the modifying impact of HDK on the associations of suspected COVID-19 symptoms (S-COVID-19-S) with anxiety and depression among hemodialysis patients. A cross-sectional study was conducted from July 2020 to March 2021 at eight hospitals across Vietnam. Data of 875 hemodialysis patients were analyzed, including socio-demographic, anxiety (the generalized anxiety disorder scale, GAD-7), depression (the patient health questionnaire, PHQ-9), S-COVID-19-S, HDK, health literacy, and digital healthy diet literacy. Confirmatory factor analysis (CFA) and logistic regression models were used to analyze the data. The HDK scale demonstrates the satisfactory construct validity with good model fit (Goodness of Fit Index, GFI = 0.96; Adjusted Goodness of Fit Index, AGFI = 0.90; Standardized Root Mean Square Residual, SRMR = 0.05; Root Mean Square Error of Approximation, RMSEA = 0.09; Normed Fit Index, NFI = 0.96; Comparative Fit Index, CFI = 0.96, and Parsimony goodness of Fit Index, PGFI = 0.43), criterion validity (as correlated with HL (r = 0.22, p < 0.01) and DDL (r = 0.19, p < 0.01), and reliability (Cronbach alpha = 0.70)). In the multivariate analysis, S-COVID-19-S was associated with a higher likelihood of anxiety (odds ratio, OR, 20.76; 95% confidence interval, 95%CI, 8.85, 48.70; p < 0.001) and depression (OR, 12.95; 95%CI, 6.67, 25.14, p < 0.001). A higher HDK score was associated with a lower likelihood of anxiety (OR, 0.70; 95%CI, 0.64, 0.77; p < 0.001) and depression (OR, 0.72; 95%CI, 0.66, 0.79; p < 0.001). In the interaction analysis, the negative impacts of S-COVID-19-S on anxiety and depression were mitigated by higher HDK scores (p < 0.001). In conclusion, HDK is a valid and reliable tool to measure dietary knowledge in hemodialysis patients. Higher HDK scores potentially protect patients with S-COVID-19-S from anxiety and depression during the pandemic.

Osteoporosis Risk in Hemodialysis Patients: The Roles of Gender, Comorbidities, Biochemical Parameters, Health and Diet Literacy

“…The level of physical activity was measured using the international physical activity questionnaire, short version [ 28 ]. The tool was validated and used in Vietnam [ 20 , 29 ]. The patients rated their time spent on four daily activities, including sitting, walking, moderate, and vigorous physical activities throughout the last seven days.…”

“…The patients rated their time spent on four daily activities, including sitting, walking, moderate, and vigorous physical activities throughout the last seven days. The overall physical activity score was calculated as per the instructions from previous studies [ 20 , 28 ].…”

“…The possible HDK score varies from 0 to 10, in which a higher score indicates better knowledge. The psychometric testing of HDK was conducted in a previous study [ 20 ].…”

“…Health literacy (HL) and digital healthy diet literacy (DDL) are defined as the individual’s capacity to find, understand, appraise, and apply the information that is related to health and digital-healthy-diet-related information in order to prevent disease, to improve healthy eating behavior, and to promote health outcomes [ 17 , 18 ]. The benefits of adequate health literacy in hemodialysis patients have been reported in prior studies, such as improved fluid management and psychological health [ 19 , 20 ]. However, there is limited information about the impacts of health literacy and digital healthy diet literacy on osteoporosis risk in hemodialysis patients.…”

Experiences of Hemodialized Patients WHO Have Recovered From Covid-19 In Medan City

“…This of course also affects their physical condition which results in a decline due to the disease they are experiencing. Study Dang et al, (2022) said that stress and anxiety were closely related to hemodialysis patients after being declared COVID-19 with a varying prevalence (from 22.5% to almost 85% for depression; from 32.3% to 44.7% for anxiety). An increase in the anxiety and stress of hemodialysis patients while in isolation at the hospital can increase the instability of the patient's health and decrease immunity, so that the patient is not able to go through the incubation period of the COVID-19 disease process properly and can result in death due to the background of the patient who has comorbidities.…”