Impacts of the COVID-19 Pandemic on Chronic Kidney Disease Care: Perspectives of Health Care Providers.

Background: The COVID-19 pandemic significantly disrupted health care delivery; however, limited research attention has addressed the impacts of the pandemic specifically on renal-based health care. Objective: The aim of the study was to understand the health and psychosocial impacts of the COVID-19 pandemic on care delivery as well as on health care providers (HCPs). Design: A qualitative Interpretive Description approach was used. Setting: Participants were recruited from kidney care units in Alberta and Ontario, Canada. Participants: 46 interdisciplinary HCPs providing kidney care during the pandemic participated in the study. Participants comprised pediatric (n=9) and adult (n=37) HCPs. Methods: Qualitative focus groups were facilitated. They were conducted using Zoom (Version 6.3.11). Results: Research results indicated substantial strain on patients and HCPs during the COVID-19 pandemic, including mental health difficulties. For HCPs, moral distress was experienced from witnessing negative impacts of the pandemic and care shifts on patients. HCPs were further deleteriously affected by staffing shortages, facility limitations due to care interruptions and resource gaps in health and community systems. Conversely, participants identified concurrent benefits from pandemic-related shifts such as the rapid transition to virtual care. While virtual care imposed challenges for physical assessment of patients, patient convenience and increased access to HCPs were noted. With training, support and experience, HCPs and patients reported an appreciation for communication offered by virtual care where appropriate. Supportive unit leaders and peer support from HCP colleagues were viewed to make this difficult experience of the pandemic more manageable. HCPs drew strength in being able to support their patients despite the difficulties of the pandemic. Limitations: Firsthand experiences of patients and families were not offered in this article, although their perspectives were elicited in another arm of this study. A more specific focus on pediatric versus adult systems of care, and the impacts of the pandemic on various disciplines, would add depth to understanding the unique impacts of the pandemic on various areas of care and across disciplines. Conclusions: Study results call for the advancement of clinical care and heightened consideration of HCP needs in a pandemic. Included recommendations are ensuring sufficient resources, prudent use of communication technology, and optimizing support to HCPs.