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Mistik S, Unalan D, Aslaner H, Tokgoz B. Evaluation of Fatigue’s Effect and Severity in Hemodialysis Patients. EURASIAN JOURNAL OF FAMILY MEDICINE 2022. [DOI: 10.33880/ejfm.2022110208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Aim: In this study, it was aimed to evaluate the effect and severity of fatigue levels in hemodialysis patients.
Methods: This cross-sectional study was conducted on 130 patients who applied to Hemodialysis units between 01 November-01 December 2019. Piper Fatigue Scale, Fatigue Impact Scale, and Fatigue Severity Scale were used as data collection tools. In statistical analysis, Student's t-test and variance analysis were used. Pearson correlation coefficient was calculated to evaluate the relationship between the variables.
Results: It is found that hemodialysis patients got the highest score on Piper Fatigue Scale from Piper Fatigue Scale - Affect (5.48±2.85) and patients felt moderately tired. Of the patients, 43.1% stated that ‘dialysis’ was the most important reason that contributes directly or causes their fatigue, and 23.1% stated that the best thing they found to reduce their fatigue was to sleep. Hemodialysis patients got the highest score on the Fatigue Impact Scale from the psychosocial (35.42±18.67) effect dimension. The mean score of the patients' Fatigue Impact Scale was 4.84±1.93. The Piper Fatigue Scale - Behavior, Piper Fatigue Scale - Affective, Piper Fatigue Scale - Sensory and Piper Fatigue Scale - Cognitive Dimension Scores, Fatigue Impact Scale - Cognitive, Fatigue Impact Scale - Physical and Fatigue Impact Scale - Psychosocial Dimension and Fatigue Impact Scale Total Scores and Fatigue Severity Scale Scores in Chronic Renal Failure patients with a chronic disease were significantly higher than in patients without chronic disease. The Fatigue Impact Scale - Cognitive, Fatigue Impact Scale - Physical, and Fatigue Impact Scale - Psychosocial dimensions, Fatigue Impact Scale total scores, and Fatigue Severity Scale scores in patients diagnosed with anemia were significantly higher than in those without anemia.
Conclusion: In our study, patients over 65 years of age and those with chronic diseases other than Chronic Renal Failure had higher levels and greater impact and severity of fatigue.
Keywords: dialysis, fatigue, severity, hemodialysis
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Affiliation(s)
- Selcuk Mistik
- Department of Family Medicine, Erciyes University Medical Faculty
| | - Demet Unalan
- Halil Bayraktar Health Services Vocational College, Erciyes University
| | | | - Bulent Tokgoz
- Department of Internal Medicine, Erciyes University Medical Faculty
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Quarta S, Levante A, García-Conesa MT, Lecciso F, Scoditti E, Carluccio MA, Calabriso N, Damiano F, Santarpino G, Verri T, Pinto P, Siculella L, Massaro M. Assessment of Subjective Well-Being in a Cohort of University Students and Staff Members: Association with Physical Activity and Outdoor Leisure Time during the COVID-19 Pandemic. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19084787. [PMID: 35457652 PMCID: PMC9025284 DOI: 10.3390/ijerph19084787] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Revised: 04/08/2022] [Accepted: 04/11/2022] [Indexed: 12/18/2022]
Abstract
Time spent outdoors and physical activity (PA) promote mental health. To confirm this relationship in the aftermath of COVID-19 lockdowns, we explored individual levels of anxiety, depression, stress and subjective well-being (SWB) in a cohort of academic students and staff members and tested their association with sport practice, PA at leisure time and time spent outdoors. Our cross-sectional study collected data during the COVID-19 outbreak (April−May 2021) on 939 students and on 238 employees, who completed an online survey on sociodemographic and lifestyle features, depression, anxiety, stress, and SWB. Results showed that the students exhibited higher levels of anxiety, depression, and stress, and lower levels of SWB (p < 0.001 for all domains) compared to the staff members. Correlation analysis confirmed that PA and time spent in nature were associated to high mental health scores among staff and, more consistently, among students. Finally, mediation analyses indicated that the time spent in nature, social relationships, and levels of energy play a mediator role in the relationship between sport practice and SWB. Our evidence reinforces the protective role of time spent in nature in improving mental health, and provides support for policymakers to make appropriate choices for a better management of COVID-19 pandemic consequences.
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Affiliation(s)
- Stefano Quarta
- Department of Biological and Environmental Sciences and Technologies (DISTEBA), University of Salento, 73100 Lecce, Italy; (S.Q.); (F.D.); (T.V.)
| | - Annalisa Levante
- Department of History, Society, and Human Studies, University of Salento, Via di Valesio, 73100 Lecce, Italy; (A.L.); (F.L.)
- Laboratory of Applied Psychology, Department of History, Society, and Human Studies, University of Salento, 73100 Lecce, Italy
| | - María-Teresa García-Conesa
- Research Group on Quality, Safety and Bioactivity of Plant Foods, Centro de Edafología y Biología Aplicada 40 del Segura-Consejo Superior de Investigaciones Científicas (CEBAS-CSIC), Campus de Espinardo, P.O. Box 164, 30100 Murcia, Spain;
| | - Flavia Lecciso
- Department of History, Society, and Human Studies, University of Salento, Via di Valesio, 73100 Lecce, Italy; (A.L.); (F.L.)
- Laboratory of Applied Psychology, Department of History, Society, and Human Studies, University of Salento, 73100 Lecce, Italy
| | - Egeria Scoditti
- Institute of Clinical Physiology (IFC), National Research Council (CNR), 73100 Lecce, Italy; (E.S.); (M.A.C.); (N.C.)
| | - Maria Annunziata Carluccio
- Institute of Clinical Physiology (IFC), National Research Council (CNR), 73100 Lecce, Italy; (E.S.); (M.A.C.); (N.C.)
| | - Nadia Calabriso
- Institute of Clinical Physiology (IFC), National Research Council (CNR), 73100 Lecce, Italy; (E.S.); (M.A.C.); (N.C.)
| | - Fabrizio Damiano
- Department of Biological and Environmental Sciences and Technologies (DISTEBA), University of Salento, 73100 Lecce, Italy; (S.Q.); (F.D.); (T.V.)
| | - Giuseppe Santarpino
- Cardiovascular Center, Paracelsus Medical University, 90471 Nuremberg, Germany;
- GVM Care and Research, Città di Lecce Hospital, 73100 Lecce, Italy
- Cardiac Surgery Unit, Department of Experimental and Clinical Medicine, University “Magna Graecia”, 88100 Catanzaro, Italy
| | - Tiziano Verri
- Department of Biological and Environmental Sciences and Technologies (DISTEBA), University of Salento, 73100 Lecce, Italy; (S.Q.); (F.D.); (T.V.)
| | - Paula Pinto
- Instituto Politécnico de Santarém, Escola Superior Agraria, 2001-904 Santarem, Portugal;
- Life Quality Research Centre (CIEQV), IPSantarém/IPLeiria, 2040-413 Rio Maior, Portugal
| | - Luisa Siculella
- Department of Biological and Environmental Sciences and Technologies (DISTEBA), University of Salento, 73100 Lecce, Italy; (S.Q.); (F.D.); (T.V.)
- Correspondence: (L.S.); (M.M.); Tel.: +39-083-229-8860 (M.M.)
| | - Marika Massaro
- Institute of Clinical Physiology (IFC), National Research Council (CNR), 73100 Lecce, Italy; (E.S.); (M.A.C.); (N.C.)
- Correspondence: (L.S.); (M.M.); Tel.: +39-083-229-8860 (M.M.)
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NAZİK F, DİŞLİ F. HEMŞİRELİK ÖĞRENCİLERİNDE GENEL SAĞLIK DURUMU YORGUNLUK ve UYKU KALİTESİ ARASINDAKİ İLİŞKİ:KESİTSEL BİR ÇALIŞMA. KAHRAMANMARAŞ SÜTÇÜ İMAM ÜNIVERSITESI TIP FAKÜLTESI DERGISI 2021. [DOI: 10.17517/ksutfd.885827] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
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Lazarus ER, Deva Amirtharaj A, Jacob D, Chandrababu R, Isac C. The effects of an olive-oil massage on hemodialysis patients suffering from fatigue at a hemodialysis unit in southern India - a randomized controlled trial. JOURNAL OF COMPLEMENTARY & INTEGRATIVE MEDICINE 2020; 18:397-403. [PMID: 34187126 DOI: 10.1515/jcim-2019-0338] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 01/27/2020] [Accepted: 07/07/2020] [Indexed: 01/14/2023]
Abstract
OBJECTIVES To determine the effects that an olive oil massage has on fatigue among patients undergoing hemodialysis, and the associated sociodemographic factors that can reduce fatigue. METHODS The study used true experimental pre- and post-test research design. A total of 200 patients were recruited in a selected hemodialysis unit in southern India and were allocated to either a study or control group by randomization, with 100 patients in each group. All the patients in the intervention group were given a lower back and lower leg massage using olive oil at the beginning, and after every hour, of their hemodialysis using olive oil for a period of eight weeks. In contrast, the control group continues to receive routine care. The level of fatigue was measured using the Fatigue Severity Scale both before and after massage therapy. RESULTS Between 73 and 80% of patients were suffering from severe fatigue and the mean fatigue score was 5.53 (SD 1.82) and 5.56 (SD 1.57) for the study and control group, respectively. After eight weeks of massage therapy, the results showed that 53% of patients in the study group showed borderline fatigue, with a mean score of 4.39 (SD 2.37), whereas in the control group 73% patients showed severe fatigue, with a mean score of 5.17 (SD 2.00). The independent t-test between the study and the control group showed a statistically significant reduction in fatigue in the study group with a mean difference (MD) of 3.56 (t=-1.24; p=0.000). There were also statistically significant changes noted in gender and in the duration of the hemodialysis (χ 2 = 6.043; p=0.049) and (χ 2 = 6.611; p=0.046) respectively. CONCLUSION The study concluded that patients undergoing hemodialysis experienced moderate to severe levels of fatigue. In patients with no or mild anemia, massage has been shown to decrease fatigue and increase energy levels among patients undergoing hemodialysis for chronic kidney disease.
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Affiliation(s)
| | | | - Devakirubai Jacob
- Department of Adult Health and Critical Care, Sultan Qaboos University, Muscat, Oman
| | - Ramesh Chandrababu
- Department of Medical-Surgical Nursing, Manipal College of Nursing, Manipal Academy of Higher Education, Manipal, India
| | - Chandrani Isac
- Department of Adult Health and Critical Care, Sultan Qaboos University, Muscat, Oman
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Salehi F, Dehghan M, Mangolian Shahrbabaki P, Ebadzadeh MR. Effectiveness of exercise on fatigue in hemodialysis patients: a randomized controlled trial. BMC Sports Sci Med Rehabil 2020; 12:19. [PMID: 32206314 PMCID: PMC7081561 DOI: 10.1186/s13102-020-00165-0] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2019] [Accepted: 02/21/2020] [Indexed: 11/17/2022]
Abstract
BACKGROUND Hemodialysis is one of the common therapies in patients with end-stage renal disease. Even patients who receive regular treatment suffer from fatigue, which is one of the main factors leading to poor quality of life. This study aimed to determine the effectiveness of exercising on mini-bikes on fatigue in hemodialysis patients. METHODS This study is a randomized controlled clinical trial. Thirty-seven hemodialysis patients participated in the study. The patients were randomly allocated to either the intervention group (n = 20) or the control group (n = 17). The participants in the intervention group exercised on mini-bikes for 20 min twice a week for 3 months. The patients' fatigue was measured four times during and after the intervention. Multidimensional Fatigue Inventory was used to measure the fatigue level. The total score in the MFI is 4 to 20 for each domain, with the resulting total fatigue score ranging from 20 to 100; thus, the higher the score, the higher the level of fatigue. Data were analyzed by SPSS 18. The repeated measures ANOVA was used to compare the fatigue scores within each group and between the groups at different times. RESULTS The mean score of fatigue in the intervention group at the beginning was 58.80 ± 15.29, which steadily decreased to 58.78 ± 13.54, 58.75 ± 14.73, 54.20 ± 15.16, and 54.23 ± 13.60 for the 3 months of intervention and 1 month post-intervention, respectively. In contrast, in the control group, this score was 62.53 ± 16.32 in the beginning, increasing to 64.03 ± 13.91, 64.22 ± 13.07, 69.53 ± 9.22, for the 3 months of intervention and 70.34 ± 7.69 one-month post-intervention. There were significant differences between the intervention group and the control group in the third month (P = 0.001) and 1 month after the intervention (P < 0.001). CONCLUSIONS The results showed that rehabilitation through exercising using mini-bikes had a significant impact on preventing further fatigue build-up in hemodialysis patients, making the mini-bike an effective non-pharmaceutical intervention preventing the increase in fatigue experienced by patients undergoing hemodialysis. TRIAL REGISTRATION Iranian Registry of Clinical Trials: IRCT20180314039100N1. Registered 10 June 2018.
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Affiliation(s)
- Farzaneh Salehi
- Clinical Research Unit, Shafa Hospital, Kerman University of Medical Sciences, Kerman, Iran
| | - Mahlagha Dehghan
- Nursing Research Center, Kerman University of Medical Sciences, Kerman, Iran
| | - Parvin Mangolian Shahrbabaki
- Nursing Research Center, Razi Faculty of Nursing and Midwifery, Kerman University of Medical Sciences, Kerman, Iran
| | - Mohammad Reza Ebadzadeh
- Department of Urology, Bahonar Hospital, Kerman University of Medical Sciences, Kerman, Iran
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Ahmadidarrehsima S, Mohammadpourhodki R, Ebrahimi H, Keramati M, Dianatinasab M. Effect of foot reflexology and slow stroke back massage on the severity of fatigue in patients undergoing hemodialysis: A semi-experimental study. JOURNAL OF COMPLEMENTARY & INTEGRATIVE MEDICINE 2018; 15:jcim-2017-0183. [PMID: 30265652 DOI: 10.1515/jcim-2017-0183] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/29/2017] [Accepted: 03/21/2018] [Indexed: 11/15/2022]
Abstract
Background Fatigue is one of the most disturbing and the most common symptoms reported by patients dialyzed. There are methods available on complementary and alternative medicine, through which nurses can help patients to promote their health. Reflexology is a treatment which has a long history and is considered as one of the most popular and the most widespread methods of alternative medicine. In this study, the effects of foot reflexology and slow stroke back massage on the severity of fatigue in patients treated with hemodialysis were measured. Methods This is a quasi-experimental study that performed on 52 patients chosen from Imam Khomeini dialysis center in Zabol and divided into control and intervention groups by randomize allocation method. Required information collected from a demographic and fatigue severity questionnaire. After completing questionnaires by the study subjects, foot massage and slow stroke back massage was performed during three weeks, two sessions each week (5 sessions in total). At the end of intervention data of two groups was collected. Data was analyzed using independent sample t-Test, Chi-squared test, Fisher exact test, oneway ANOVA with repeated measures and Bonferroni test by SPSS software version 21. Results The mean [±SD] fatigue in patients with foot reflexology massage and slow stroke back massage reflect on the 53.61[±10.12] and 52.20 [±10.37], and the differences were not significant, but after the intervention, fatigue in the group receiving foot reflexology massage was reduced significantly compared to slow stroke back massage group (p<0.0001). Conclusions The result of this study showed that reflexology massage is a safe and economical nursing intervention for decreasing fatigue in hemodialysis patients.
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Affiliation(s)
| | - Reza Mohammadpourhodki
- School of Nursing and Midwifery, Shahroud University of Medical Sciences, Shahroud, Iran
| | - Hossein Ebrahimi
- School of Nursing and Midwifery, Shahroud University of Medical Sciences, Shahroud, Iran
| | - Maryam Keramati
- School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mostafa Dianatinasab
- Shiraz HIV/AIDS Research Center, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran
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Relationship between fatigue symptoms and subjective and objective indicators in hemodialysis patients. Int Urol Nephrol 2018; 50:1329-1339. [PMID: 29728995 DOI: 10.1007/s11255-018-1871-4] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2017] [Accepted: 04/11/2018] [Indexed: 02/05/2023]
Abstract
PURPOSE The purpose of the study was to investigate the major factors affecting fatigue symptoms and to examine the relationships between fatigue symptoms and subjective and objective indicators in patients on hemodialysis (HD). METHODS Patients on HD who met the inclusion criteria were chosen from two grade A tertiary general hospitals by convenience sampling and cross-sectional survey methods. RESULTS A total of 511 patients were included in the study. The morbidity rate of fatigue in patients on HD was 61.6%, and the median fatigue level was 3.91. Fatigue and subjective indicators showed a mild-moderate relationship (0.3 < all |r| < 0.6, all P < 0.001), whereas a weak correlation was found between fatigue and objective indicators (all |r| < 0.2, all P < 0.05). Multivariate analysis showed that subjective indicators, including employment, exercise time, appetite, the vitality of 36-item Short Form Health Survey, perceived social support, intrafamilial support, cramping, headache, chest tightness, and whole-body pain, as well objective indicator, such as serum intact parathyroid hormone levels, were the influence factors of fatigue in patients on HD. CONCLUSION The prevalence of fatigue symptoms was high and the level of fatigue was moderate in patients on HD. Subjective and objective indicators can both affect fatigue symptoms in patients on HD.
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Dimitriadou E, Giannaki CD, Tsekoura M, Stefanidis I, Hadjigeorgiou GM, Lavdas E, Karatzaferi C, Sakkas GK. Restless legs syndrome/Willis-Ekbom disease prevalence in beta thalassemia patients. Sleep Breath 2017; 22:175-179. [PMID: 28425083 DOI: 10.1007/s11325-017-1497-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2016] [Revised: 02/13/2017] [Accepted: 03/28/2017] [Indexed: 11/30/2022]
Abstract
PURPOSE Both beta thalassemia and restless legs syndrome (RLS) patients share some common pathophysiological characteristics related to iron handling. In the present study, the aim was to explore the prevalence of RLS as well as to explore potential association between the syndrome and various quality of life-related parameters in a sample of beta thalassemia patients. METHODS One hundred fourteen (age 40 ± 11 yr, 59 M/55F) beta thalassemia patients participated in this cross-sectional descriptive study. Patients were screened for RLS based on the international RLS study group diagnostic criteria as well as a battery of validated questionnaires. RESULTS The prevalence of RLS in this sample of beta thalassemia patients was zero. The quality of life score was low (78 ± 18). Iron levels were within normal range (191 ± 66 mcg/dL) while ferritin levels were high as expected (1836 ± 225 ng/dL). CONCLUSIONS Our sample of patients comes from central Greece where the prevalence of RLS in the general population is 4% while in renal failure patients is 27%. To our surprise, there was no presence of RLS among this sample of beta thalassemia patients. The adequate levels of iron and ferritin often seen in these patients could be the reason of the absence of RLS symptoms.
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Affiliation(s)
| | | | - Maria Tsekoura
- Department of PE and Sport Science, University of Thessaly, Trikala, Greece
| | - Ioannis Stefanidis
- School of Health Science, Department of Medicine, University of Thessaly, Larissa, Greece
| | | | - Eleftherios Lavdas
- Department of Medical Radiological Technologists, Technological Education Institute of Athens, Athens, Greece
| | - Christina Karatzaferi
- Department of PE and Sport Science, University of Thessaly, Trikala, Greece.,Faculty of Sport and Health Sciences, School of Sport and Health Science, University of St Mark and St John, Derriford Rd, PL68BH, Plymouth, UK
| | - Giorgos K Sakkas
- Department of PE and Sport Science, University of Thessaly, Trikala, Greece. .,Faculty of Sport and Health Sciences, School of Sport and Health Science, University of St Mark and St John, Derriford Rd, PL68BH, Plymouth, UK.
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Hadadian F, Sohrabi N, Farokhpayam M, Farokhpayam H, Towhidi F, Fayazi S, Soroush A, Abdi A. The Effects of Transcutaneous Electrical Acupoint Stimulation (TEAS) on Fatigue in Haemodialysis Patients. J Clin Diagn Res 2016; 10:YC01-YC04. [PMID: 27790566 DOI: 10.7860/jcdr/2016/19516.8532] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2016] [Accepted: 05/14/2016] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Fatigue is one of the most common symptom in End-stage renal disease (ESRD) patients receiving haemodialysis treatment. In recent years, researchers investigated the role of alternative medicine methods such as acupuncture in treatment of the chronic disease; however, there is a paucity of information regarding the fatigue of haemodialysis patients. AIM To evaluate the effects of Trans Cutaneous Electrical Acupoint Stimulation (TEAS) on fatigue among ESRD patients receiving haemodialysis treatment. MATERIALS AND METHODS This randomized clinical trial was conducted over a five month, in Kermanshah-Iran haemodialysis centers in 2009. Fifty six patients who had undergone haemodialysis and meeting the inclusion criteria, were divided into two groups by simple random sampling; TEAS (28 cases) and TEAS-Sham group (28 cases). The data was gathered through the Brief Fatigue Inventory (BFI), entered into SPSS-16 software and analysed by descriptive and inferential statistics. RESULTS Out of 56, 38 patients (67.9%) were male and 45 (80.4%) were married. The mean and standard deviation of age were 52.29±15.26 years. The inferential tests showed no differences in the clinical and the demographic characteristics of patients among two groups (p > 0.05). The mean rank of fatigue score in TEAS and TEAS-Sham groups was 30.68 and 26.32 respectively (p=0.317) at the first of study. The results of the Mann-Whitney U-test indicated that there were significant differences between the TEAS and Sham groups after intervention (p = 0.002). CONCLUSION Findings of the present study revealed that application of the TEAS on these acupoints had produced a better recovery rate of fatigue in TEAS group than Sham group after a course of ten session intervention. So, it is suggested that this plan be provided to the haemodialysis patients.
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Affiliation(s)
- Fatemeh Hadadian
- Nursing Mentor, Deparment of Medical Surgical Nursing, School of Nursing and Midwifery, Kermanshah University of Medical Sciences , Kermanshah, Iran
| | - Nasrollah Sohrabi
- Assistant Professor, Department of Medical Laboratory Sciences, School of Paramedicine, Kermanshah University of Medical Sciences , Kermanshah, Iran
| | - Mandana Farokhpayam
- Student, Department of Pharmacy School, International Branch of Shahid Beheshti University of Medical Sciences , Tehran, Iran
| | - Hoda Farokhpayam
- Student, Department of Pharmacy School, International Branch of Shahid Beheshti University of Medical Sciences , Tehran, Iran
| | - Farhad Towhidi
- Phd Student, Medical Surgical Nursing, Imam Reza Hospital, Kermanshah University of Medical Sciences , Kermanshah, Iran
| | - Sadighe Fayazi
- Nursing Mentor, Chronic Disease Care Research Center, Department of Nursing and Midwifery, School of Nursing and Midwifery, Ahvaz Jundishapur University of Medical Sciences , Ahvaz, Iran
| | - Ali Soroush
- Assistant Professor, Lifestyle Modification Research Centre, Imam Reza Hospital, Kermanshah University of Medical Sciences , Kermanshah, Iran
| | - Alireza Abdi
- Phd of Nursing, Department of Nursing, Nursing and Midwifery School, Shahid Beheshti University of Medical Sciences , Tehran, Iran
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Flythe JE, Powell JD, Poulton CJ, Westreich KD, Handler L, Reeve BB, Carey TS. Patient-Reported Outcome Instruments for Physical Symptoms Among Patients Receiving Maintenance Dialysis: A Systematic Review. Am J Kidney Dis 2015. [PMID: 26210069 DOI: 10.1053/j.ajkd.2015.05.020] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
BACKGROUND Patients with end-stage renal disease (ESRD) receiving dialysis have poor health-related quality of life. Physical symptoms are highly prevalent among dialysis-dependent patients and play important roles in health-related quality of life. A range of symptom assessment tools have been used in dialysis-dependent patients, but there has been no previous systematic assessment of the existing symptom measures' content, validity, and reliability. STUDY DESIGN Systematic review of the literature. SETTINGS & POPULATION Patients with ESRD on maintenance dialysis therapy. SELECTION CRITERIA FOR STUDIES Instruments with 3 or more physical symptoms previously used in dialysis-dependent patients and evidence of validity or reliability testing. INTERVENTION Patient-reported physical symptom assessment instrument. OUTCOMES Instrument symptom-related content, validity, and reliability. RESULTS From 3,148 screened abstracts, 89 full-text articles were eligible for review. After article exclusion and further article identification by reference reviews, 58 articles on 23 symptom assessment instruments with documented reliability or validity testing were identified. Of the assessment instruments, 43.5% were generic and 56.5% were ESRD specific. Symptoms most frequently assessed were fatigue, shortness of breath, insomnia, nausea and vomiting, and appetite. Instruments varied widely in respondent time burden, recall period, and symptom attributes. Few instruments considered recall periods less than 2 weeks and few assessed a range of symptom attributes. Psychometric testing was completed for congruent validity (70%), known-group validity (25%), responsiveness (30%), internal consistency (78%), and test-retest reliability (65%). Content validity was assessed in dialysis populations in 57% of the 23 instruments. LIMITATIONS Consideration of physical symptoms only and exclusion of single symptom-focused instruments. CONCLUSIONS The number of available instruments focused exclusively on physical symptoms in dialysis patients is limited. Few symptom-containing instruments have short recall periods, assess diverse symptom attributes, and have undergone comprehensive psychometric testing. Improved symptom-focused assessment tools are needed to improve symptom evaluation and symptom responsiveness to intervention among dialysis-dependent patients.
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Affiliation(s)
- Jennifer E Flythe
- University of North Carolina Kidney Center, Division of Nephrology and Hypertension, Department of Medicine, University of North Carolina School of Medicine, Chapel Hill, NC; The Cecil G. Sheps Center for Health Services Research, Chapel Hill, NC.
| | - Jill D Powell
- University of North Carolina Kidney Center, Division of Nephrology and Hypertension, Department of Medicine, University of North Carolina School of Medicine, Chapel Hill, NC
| | - Caroline J Poulton
- University of North Carolina Kidney Center, Division of Nephrology and Hypertension, Department of Medicine, University of North Carolina School of Medicine, Chapel Hill, NC
| | - Katherine D Westreich
- University of North Carolina Kidney Center, Division of Nephrology and Hypertension, Department of Medicine, University of North Carolina School of Medicine, Chapel Hill, NC
| | - Lara Handler
- Health Sciences Library, University of North Carolina, Chapel Hill, NC
| | - Bryce B Reeve
- The Cecil G. Sheps Center for Health Services Research, Chapel Hill, NC; Department of Health Policy and Management, University of North Carolina Gillings School of Global Public Health, Chapel Hill, NC
| | - Timothy S Carey
- The Cecil G. Sheps Center for Health Services Research, Chapel Hill, NC; Division of General Internal Medicine and Clinical Epidemiology, Department of Medicine, University of North Carolina School of Medicine, Chapel Hill, NC
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Floege J. Magnesium in CKD: more than a calcification inhibitor? J Nephrol 2014; 28:269-77. [PMID: 25227765 PMCID: PMC4439441 DOI: 10.1007/s40620-014-0140-6] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2014] [Accepted: 09/02/2014] [Indexed: 01/30/2023]
Abstract
Magnesium fulfils important roles in multiple physiological processes. Accordingly, a tight regulation of magnesium homeostasis is essential. Dysregulated magnesium serum levels, in particular hypomagnesaemia, are common in patients with chronic kidney disease (CKD) and have been associated with poor clinical outcomes. In cell culture studies as well as in clinical situations magnesium levels were associated with vascular calcification, cardiovascular disease and altered bone-mineral metabolism. Magnesium has also been linked to diseases such as metabolic syndrome, diabetes, hypertension, fatigue and depression, all of which are common in CKD. The present review summarizes and discusses the latest clinical data on the impact of magnesium and possible effects of higher levels on the health status of patients with CKD, including an outlook on the use of magnesium-based phosphate-binding agents in this context.
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Affiliation(s)
- Jürgen Floege
- Division of Nephrology and Clinical Immunology, RWTH University of Aachen, Pauwelsstr. 30, 52057, Aachen, Germany,
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Biniaz V, Tayybi A, Nemati E, Sadeghi Shermeh M, Ebadi A. Different aspects of fatigue experienced by patients receiving maintenance dialysis in hemodialysis units. Nephrourol Mon 2013; 5:897-900. [PMID: 24350089 PMCID: PMC3842561 DOI: 10.5812/numonthly.11667] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2013] [Revised: 06/02/2013] [Accepted: 07/16/2013] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Fatigue, a common symptom reported by patients receiving dialysis, is a multidimensional and subjective experience which is readily understood by individuals but difficult to measure. OBJECTIVES This study was performed to identify the prevalence of differential aspects of fatigue among patients receiving maintenance dialysis. PATIENTS AND METHODS The cross-sectional study was conducted in two hemodialysis wards in Tehran with a sample of 163 participants. In this study, the multidimensional fatigue inventory was used to determine the level of fatigue. Demographic data were also collected with self-report survey. To analyze data with SPSS statistical software, test Chi square, T-test, and ANOVA were used. P- Value less than 0.05 was considered significant. RESULTS All the patients experienced degrees of fatigue and 50 (30.7%) of the participants experienced a high level of fatigue. Fatigue scores arrangement was founded for physical fatigue followed by reduced activity and general fatigue. Lower levels of fatigue were reported for mental fatigue and reduced motivation. There was no diversity in this study in the levels of fatigue in respects of gender and marital status and employment status. Participants with diabetic nephropathy were the most fatigued. CONCLUSIONS People with chronic kidney disease regardless of their age, gender, state of health, and duration of hemodialysis experience high levels of fatigue; it is particularly important for health providers to understand this level of fatigue which affects the daily life of patients.
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Affiliation(s)
- Vajihe Biniaz
- Nephrology and Urology Department, Baqiyatallah University of Medical Sciences, Tehran, IR Iran
| | - Ali Tayybi
- Department of Medical Surgical Nursing, Baqiyatallah University of Medical Sciences, Tehran, IR Iran
| | - Eghlim Nemati
- Nephrology and Urology Department, Baqiyatallah University of Medical Sciences, Tehran, IR Iran
| | - Mehdi Sadeghi Shermeh
- Department of Medical Surgical Nursing, Baqiyatallah University of Medical Sciences, Tehran, IR Iran
- Corresponding author: Mehdi Sadeghi Shermeh, Velayat Complex, Nobonyad square, Tehran, IR Iran. Tel: +98-9121549042, Fax: +98-2126127253, E-mail:
| | - Abbas Ebadi
- Department of Medical Surgical Nursing, Baqiyatallah University of Medical Sciences, Tehran, IR Iran
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Al-Jahdali HH, Khogeer HA, Al-Qadhi WA, Baharoon S, Tamim H, Al-Hejaili FF, Al-Ghamdi SM, Al-Sayyari AA. Insomnia in chronic renal patients on dialysis in Saudi Arabia. J Circadian Rhythms 2010; 8:7. [PMID: 20546577 PMCID: PMC2898657 DOI: 10.1186/1740-3391-8-7] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2010] [Accepted: 06/14/2010] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Studies have shown that insomnia is a common sleep disorder among patients with end-stage renal disease (ESRD). This study aimed to assess the prevalence of insomnia in Saudi patients with ESRD who are on maintenance dialysis. METHODS This was an observational cross-sectional study carried out over a period of five months in two hemodialysis centers in Saudi Arabia. To assess the prevalence of insomnia, we used the ICSD-2 definition. We also examined the association between insomnia and other sleep disorders, the underlying causes of renal failure, dialysis duration, dialysis shift, and other demographic data. RESULTS Out of 227 enrolled patients, insomnia was reported by 60.8%. The mean patient age was 55.7 +/- 17.2 years; 53.7% were male and 46.3% were female. Insomnia was significantly associated with female gender, afternoon hemodialysis, Restless Legs Syndrome, high risk for obstructive Sleep Apnea Syndrome and excessive daytime sleepiness (P-values: 0.05, 0.01, < 0.0001, < 0.0001, and < 0.0001, respectively). No significant association was found between insomnia and other variables, including BMI, smoking habits, underlying etiology of renal failure, dialysis duration, association with hemoglobin, ferritin, and phosphorus or dialysis adequacy as measured by the Kt/V index. CONCLUSION Insomnia is common in dialysis patients and was significantly associated with other sleep disorders. Greater attention needs to be given to the care of dialysis patients with regard to the diagnosis and management of insomnia and associated sleep disorders.
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Affiliation(s)
- Hamdan H Al-Jahdali
- Division of Pulmonary/Sleep Disorders Center, King Saud University for Health Sciences, Riyadh- Saudi Arabia.
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