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Faioli A, Bergesio G, Samà C, Gallo B. Predictors of Fatigue Among Patients on Hemodialysis: An Observational Study. Cureus 2024; 16:e65953. [PMID: 39221326 PMCID: PMC11365537 DOI: 10.7759/cureus.65953] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/01/2024] [Indexed: 09/04/2024] Open
Abstract
Background Hemodialysis is a chronic replacement therapy recommended during end-stage renal disease (ESRD) in chronic kidney disease (CKD). Post-dialysis fatigue (PDF) is one of the symptoms patients experience after the treatment. This multifactorial condition is subjective and characterized by a lack of physical and emotional energy. It can be associated with other symptoms such as nausea, headache, muscle cramps, and hypotension. Currently, researchers have not been able to find defined etiologies and pathogenesis. This study aims to analyze the influence of PDF predictors within a sample of patients undergoing hemodialysis. Methodology A multicenter, observational study was conducted on a convenience sample of 250 CKD patients with ESRD on hemodialysis between February and July 2023. PDF was assessed using the Piper Fatigue Scale (PFS), administered in both paper and electronic formats. The data analysis was done using descriptive and inferential statistics and correlation tests. Results The analysis revealed that sleep disorders perceived (p = 0.0001; τ = 0.23), the presence of comorbidity (p = 0.003; τ = 0.18), the number of weekly sessions (p = 0.012; τ = 0.15), and the period of hemodialysis (p = 0.0069; τ = 0.15) had a positive correlation with the PFS score. The study highlighted that hemoglobin level (p = 0.017; τ = - 0.14) and sex (p = 0.012; τ = 0.15) affected the PDF perception. Patients who engaged in physical activities or used distraction techniques (p = 1.83e-05; τ = 0.26) to alleviate PDF reported lower average scores on the PFS (2.27 points) compared to those who did not engage in any such activities. Conclusions Hemodialysis appears to be a source of stress for most patients, as they showed a moderate-to-severe score on the PFS scale. PDF is a multifactorial problem that must be recognized and treated properly by nurses through pharmacological therapies, as well as by educating and providing alternative strategies, that can contribute to alleviating the effects of fatigue.
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Affiliation(s)
- Alessia Faioli
- Department of Long-Term Care, Hospital Cardinal Massaia, Asti, ITA
| | - Giorgio Bergesio
- Department of Sciences of Public Health and Pediatrics, University of Turin, Asti, ITA
| | - Carmen Samà
- Department of Orthopedics, Hospital Cardinal Massaia, Asti, ITA
| | - Benedetta Gallo
- Department of Long-Term Care, Rehabilitation and Physical Therapy Center of the Turati Foundation, Pistoia, ITA
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Huang LT, Zheng XY, Zhang ZH, Zheng HY, Wei X, Yang JY, Zhang LH, Lu XQ, Yang YQ, Lin JX, Zhang CM, Luo LP, Jiang DH, Huang SH, Huang XB, Zhan YM, Xu WZ, Han W, Hong FY. Translation, cultural adaptation, and validation of the Chinese standardized outcomes in nephrology-hemodialysis fatigue (C-SONG-HD fatigue) scale: a study of Chinese patients undergoing hemodialysis. Qual Life Res 2024; 33:745-752. [PMID: 38064016 DOI: 10.1007/s11136-023-03561-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/04/2023] [Indexed: 02/26/2024]
Abstract
OBJECTIVE This study aimed to translate and culturally adapt the standardized outcomes in nephrology-hemodialysis fatigue (SONG-HD fatigue) scale and to assess the psychometric properties of the Chinese version of the SONG-HD fatigue (C-SONG-HD fatigue) scale. METHODS Forward and back translations were used to translate the SONG-HD fatigue scale into Chinese. We used the C-SONG-HD fatigue scale to survey Chinese patients undergoing hemodialysis (HD) in China. We examined the distribution of responses and floor and ceiling effects. Cronbach's alpha and McDonald's omega coefficient, intraclass coefficients, and Spearman correlations were used to assess internal consistency reliability, test-retest reliability, and convergent validity, respectively. Responsiveness was also evaluated. RESULTS In total, 489 participants across southeast China, northwest China, and central China completed the study. The C-SONG-HD fatigue scale had good internal consistency (Cronbach's alpha coefficient 0.861, omega coefficient 0.916), test-retest reliability (intraclass correlation coefficient 0.695), and convergent validity (Spearman correlation 0.691). The analysis of all first-time HD patients did not show notable responsiveness, and only patients with temporary vascular access had good responsiveness with an effect size (ES) of 0.54, a standardized response mean (SRM) of 0.85, and a standard error of measurement (SEM) of 0.77. CONCLUSION The Chinese version of the SONG-HD fatigue scale showed satisfactory reliability and validity in patients undergoing hemodialysis (HD) in China. It could be used as a tool to measure the fatigue of Chinese HD patients.
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Affiliation(s)
- Lan-Ting Huang
- Department of Nephrology, Fujian Provincial Hospital and Fujian Medical University, Fuzhou, Fujian, China.
| | - Xiao-Yan Zheng
- Department of Blood Purification, Fujian Provincial Hospital and Fujian Medical University, Fuzhou, Fujian, China
| | - Zhi-Hong Zhang
- Department of Blood Purification, Fujian Provincial Hospital and Fujian Medical University, Fuzhou, Fujian, China
| | - Hong-Yan Zheng
- Department of Blood Purification, Renhe Hospital of Hubei Three Gorges University, Yichang, Hubei, China
| | - Xin Wei
- Department of Blood Purification, Xinjiang Changji Hui Autonomous Prefecture Hospital of Traditional Chinese Medicine, Changji, Xinjiang, China
| | - Ji-Yan Yang
- Department of Blood Purification, Pengyang People's Hospital of Ningxia Hui Autonomous Region, Pengyang, Ningxia, China
| | - Li-Hua Zhang
- Department of Blood Purification, Fuzhou First Hospital, Fuzhou, Fujian, China
| | - Xiu-Qin Lu
- Department of Blood Purification, Fuzhou General Hospital, Fuzhou, Fujian, China
| | - Ying-Qing Yang
- Department of Blood Purification, Affiliated Hospital of Putian University, Putian, Fujian, China
| | - Jin-Xia Lin
- Department of Blood Purification, Quanzhou First Hospital, Quanzhou, Fujian, China
| | - Chun-Mei Zhang
- Department of Blood Purification, Wuyishan Municipal Hospital, Wuyishan, Fujian, China
| | - Li-Ping Luo
- Department of Blood Purification, Nanping People's Hospital, Nanping, Fujian, China
| | - Dong-Hua Jiang
- Department of Blood Purification, Sanming Second Hospital, Sanming, Fujian, China
| | - Shao-Hua Huang
- Department of Blood Purification, Sanming First Hospital, Sanming, Fujian, China
| | - Xiu-Bi Huang
- Department of Blood Purification, Zhangzhou Hospital, Zhangzhou, Fujian, China
| | - Yue-Mei Zhan
- Department of Blood Purification, Longyan First Hospital, Longyan, Fujian, China
| | - Wen-Zhu Xu
- Department of Blood Purification, Ningde Mindong Hospital, Mindong, Fujian, China
| | - Wei Han
- Department of Blood Purification, Xiamen Zhongshan Hospital, Xiameng, Fujian, China
| | - Fu-Yuan Hong
- Department of Nephrology, Fujian Provincial Hospital and Fujian Medical University, Fuzhou, Fujian, China.
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Khemchandani M, Nasir K, Qureshi R, Dhrolia M, Ahmad A. From Exhaustion to Empowerment: Investigating Fatigue and Its Associations in Patients With End-Stage Renal Disease on Maintenance Hemodialysis. Cureus 2023; 15:e49070. [PMID: 38125257 PMCID: PMC10730779 DOI: 10.7759/cureus.49070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/17/2023] [Indexed: 12/23/2023] Open
Abstract
Introduction Patients with end-stage renal disease (ESRD) receiving maintenance hemodialysis (MHD) frequently experience fatigue. This cross-sectional study examined the severity of fatigue and the demographic and clinical characteristics that may contribute to fatigue in ESRD patients on MHD. Methods The study included 250 ESRD patients on MHD. Age, gender, marital status, occupation, level of education, and information regarding dialysis and laboratory parameters were gathered. The Fatigue Assessment Scale (FAS) was used to quantify fatigue. The FAS consisted of 10 questions. Fatigue severity was categorized into three groups based on the total FAS score. Results The mean fatigue score using FAS in our study was 22.1 ± 4.1 (47.2%), indicating a moderate level of fatigue among the participants. Approximately 47.2% of the patients reported moderate fatigue, while severe fatigue was not observed in our study. Employment status showed a significant association with fatigue, with a higher prevalence among unemployed individuals 56 (47.5%) and those engaged in housework 40 (33.9%). The duration of hemodialysis was also significantly associated with fatigue in our study (p < 0.001), with patients undergoing treatment for more than 4 years experiencing a higher prevalence of 81 (68.7%). Among the demographic and clinical parameters analyzed, age, gender, residence, education, socioeconomic status, and comorbid conditions did not show a significant association with fatigue. However, phosphorus levels demonstrated a significant association (p = 0.014), with higher levels being associated with a decreased chance of experiencing fatigue. Conclusion These findings suggest that employment status and the duration of hemodialysis are potential factors influencing fatigue in ESRD patients on MHD. Furthermore, it is possible that phosphorus levels affect how tiredness manifests. Understanding these factors can contribute to improved management and timely interventions to address fatigue in this patient population. It is important to conduct more studies to understand the causes of fatigue in ESRD patients receiving MHD, as well as possible treatments.
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Affiliation(s)
| | - Kiran Nasir
- Nephrology, The Kidney Centre Post Graduate Training Institute, Karachi, PAK
| | - Ruqaya Qureshi
- Nephrology, The Kidney Centre Post Graduate Training Institute, Karachi, PAK
| | - Murtaza Dhrolia
- Nephrology, The Kidney Centre Post Graduate Training Institute, Karachi, PAK
| | - Aasim Ahmad
- Nephrology, The Kidney Center Post Graduate Training Institute, Karachi, PAK
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Ouyang Q, Yang F, Wu H, Tang S, Peng X, Li Y, Wang J. The Effects of Dialysis Modality and Emotional Distress on Fatigue in Patients Undergoing Dialysis. Blood Purif 2023; 52:751-758. [PMID: 37703855 DOI: 10.1159/000532058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Accepted: 07/13/2023] [Indexed: 09/15/2023]
Abstract
INTRODUCTION Fatigue is a common but often overlooked symptom in dialysis patients. Factors affecting fatigue in dialysis patients are currently unclear. There are few studies on the effects of mental factors and dialysis modality on fatigue. This study aims to explore the potential relationship between fatigue and insomnia, as well as psychiatric disorders such as anxiety and depression among patients who undergo peritoneal dialysis (PD) or hemodialysis (HD). METHODS There were 96 HD patients and 160 PD patients at our hospital who voluntarily participated in the survey. A questionnaire survey was conducted to gather general characteristics of the patients and to evaluate fatigue, sleep quality, anxiety, and depression levels among PD and HD patients. RESULTS The overall fatigue score was 53.83 ± 14.22 for the PD group and 57.92 ± 16.35 for the HD group. Notably, the fatigue level was lower in the PD group compared to the HD group (p < 0.05). Univariate analysis indicated that fatigue was associated with occupational status and income in the PD group, as well as educational level and income in the HD group (p < 0.05). Correlation analysis revealed that patients in both groups who were older and had higher scores for insomnia, anxiety, and depression experienced more severe fatigue. Moreover, body mass index was positively correlated with fatigue status in the PD group, while duration of dialysis showed a positive association with fatigue in the HD group. Multivariate regression analysis identified income and depression as major factors influencing fatigue in the PD group, and duration of dialysis, income, and depression in the HD group. CONCLUSION Patients who undergo dialysis exhibit high levels of fatigue, with the severity of fatigue being less pronounced in the PD group compared to the HD group. Fatigue in these patients is associated with the duration of dialysis, income level, and presence of depression.
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Affiliation(s)
- Qin Ouyang
- Department of Nephropathy, Third Xiangya Hospital of Central South University, Changsha, China
| | - Fengjie Yang
- Department of Pediatrics, Third Xiangya Hospital of Central South University, Changsha, China
| | - Hong Wu
- Department of Anesthesiology, Third Xiangya Hospital of Central South University, Changsha, China
| | - Shiqi Tang
- Department of Nephropathy, Third Xiangya Hospital of Central South University, Changsha, China
| | - Xinyue Peng
- Department of Nephropathy, Third Xiangya Hospital of Central South University, Changsha, China
| | - Yuxin Li
- Department of Nephropathy, Third Xiangya Hospital of Central South University, Changsha, China
| | - Jianwen Wang
- Department of Nephropathy, Third Xiangya Hospital of Central South University, Changsha, China
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Asad HN, Al-Hakeim HK, Moustafa SR, Maes M. A Causal-Pathway Phenotype of Chronic Fatigue Syndrome due to Hemodialysis in Patients with End-Stage Renal Disease. CNS & NEUROLOGICAL DISORDERS DRUG TARGETS 2023; 22:191-206. [PMID: 35366785 DOI: 10.2174/1871527321666220401140747] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Revised: 11/27/2021] [Accepted: 12/24/2021] [Indexed: 12/16/2022]
Abstract
BACKGROUND End-stage renal disease (ESRD) is associated with fatigue and physiosomatic symptoms. OBJECTIVE The objective of this study is to delineate the associations between severity of fatigue and physio-somatic symptoms and glomerular filtration rate, inflammatory biomarkers, and Wnt/cateninpathway proteins. METHODS The Wnt-pathway related proteins β-catenin, Dickkopf-related protein 1 (DKK1), R-spondin- 1, and sclerostin were measured by ELISA technique in 60 ESRD patients and 30 controls. The Fibromyalgia and Chronic Fatigue Syndrome (FF) Rating Scale was used to assess the severity of FF symptoms. RESULTS ESRD is characterized by a significant increase in the total FF score, muscle tension, fatigue, sadness, sleep disorders, gastro-intestinal (GI) symptoms, and a flu-like malaise. The total-FF score was significantly correlated with serum levels of urea, creatinine, and copper (positively), and β-catenin, eGFR, hemoglobin, albumin, and zinc (inversely). The total-FF score was associated with the number of total dialysis and weekly dialysis sessions, and these dialysis characteristics were more important in predicting FF scores than eGFR measurements. Partial Least Squares analysis showed that the FF score comprised two factors that are differently associated with biomarkers: a) 43.0% of the variance in fatigue, GI symptoms, muscle tension, sadness, and insomnia is explained by hemoglobin, albumin, zinc, β-catenin, and R-spondin-1; and b) 22.3% of the variance in irritability, concentration and memory impairments by increased copper and cations/chloride ratio, and male sex. CONCLUSION ESRD patients show high levels of fatigue and physio-somatic symptoms associated with hemodialysis and mediated by dialysis-induced changes in inflammatory pathways, the Wnt/catenin pathway, and copper.
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Affiliation(s)
- Halah Nori Asad
- Al Najaf Health Directorate, Higher Health Institute, Najaf, Iraq
| | | | - Shatha Rouf Moustafa
- Department of Clinical Analysis, College of Pharmacy, Hawler Medical University, Erbil, Iraq
| | - Michael Maes
- Department of Psychiatry, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
- Department of Psychiatry, Medical University of Plovdiv, Plovdiv, Bulgaria
- School of Medicine, IMPACT Strategic Research Centre, Deakin University, VIC, 3220, Australia
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Cahyati Y, Rosdiana I. Contribution of anxiety and dialysis factors to the event of fatigue in hemodialysis patient. ENFERMERÍA NEFROLÓGICA 2022. [DOI: 10.37551/2254-28842022017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
Introduction: Fatigue is one of the most common symptoms felt by chronic renal failure patients undergoing hemodialysis (HD). The prevalence ranges from 42-97% with levels varying from low to severe. Fatigue is not only detrimental to physical and social functioning but is also associated with poor quality of life for HD patients and is associated with death in patients undergoing chronic hemodialysis. For this reason, it is necessary to know the factors associated with the incidence of fatigue so that appropriate interventions can be carried out, both pharmacologically and non-pharmacologically.Objective: To evaluate the influence of anxiety and dialysis factors on the incidence of fatigue in patients undergoing hemodialysis at Ciamis Hospital.Material and Method: A cross sectional approach with a total sample of 88 people was used.Results: The results showed that 78 respondents (88.6%) who experienced fatigue complaints and anxiety had a relationship with the incidence of fatigue (OR: 9.0; p=0.019).Conclusions: Psychological factors, such as anxiety, are associated with the fatigue experienced by patients on hemodialysis.
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Affiliation(s)
- Yanti Cahyati
- Poltekkes Kemenkes Tasikmalaya. Indonesia. Health and Disaster Emergency (HADE) Center. Center of Excellence. Poltekkes Kemenkes Tasikmalaya. Indonesia
| | - Ida Rosdiana
- Poltekkes Kemenkes Tasikmalaya. Indonesia. Centro de Emergencias Sanitarias y Catástrofes (HADE). Centro de Excelencia. Poltekkes Kemenkes Tasikmalaya. Indonesia
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Carlos C, Grimes B, Segal M, Johansen K. Predialysis fluid overload and gait speed: a repeated measures analysis among patients on chronic dialysis. Nephrol Dial Transplant 2020; 35:1027-1031. [PMID: 31886859 DOI: 10.1093/ndt/gfz272] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2019] [Accepted: 11/07/2019] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Slow gait speed is associated with hospitalization and death. We examined whether predialysis fluid overload contributes to gait speed impairment. METHODS We measured predialysis gait speed at baseline and 12 and 24 months among 298 patients recruited in the A Cohort Study to Investigate the Value of Exercise in ESRD/Analyses Designed to Investigate the Paradox of Obesity and Survival in ESRD. We used multivariable linear mixed modeling to examine associations between patient data and gait speed. We then added either bioimpedance-estimated volume of predialysis fluid overload or volume of delivered ultrafiltration to ascertain whether fluid excess was associated with gait speed and its trajectory. We also tested whether fluid overload change with time was predictive of gait speeds. RESULTS The mean baseline gait speed was 1.01 m/s and it declined by an average of 0.08 m/s/year. Older age, nonwhite race, Hispanic ethnicity, diabetes, recent fall, recent hospitalization, tobacco use and lower serum albumin were associated with slower gait speed. Each liter of predialysis fluid overload was associated with a 0.02 m/s slower gait speed [95% confidence interval (CI) 0.01-0.04, P = 0.008] and 0.05 m/s additional slowing per year (95% CI 0.03-0.06, P < 0.0001). Higher ultrafiltration volumes were associated with 0.07 m/s slower gait speed per 3% body weight removed (0.002-0.14, P = 0.045) but not with gait speed trajectory (P = 0.08). Patients who increased fluid overload walked 0.08 m/s slower compared with those who decreased fluid overload (95% CI 0.003-0.15, P = 0.04). CONCLUSIONS Predialysis fluid overload was associated with slower gait speed and gait speed decline over time. Interventions that limit fluid overload may lead to improvements in physical performance.
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Affiliation(s)
- Christopher Carlos
- Division of Nephrology, University of California, San Francisco, San Francisco, CA, USA
| | - Barbara Grimes
- Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, CA, USA
| | - Mark Segal
- Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, CA, USA
| | - Kirsten Johansen
- Division of Nephrology, Hennepin County Medical Center, Minneapolis, MN, USA.,Division of Nephrology, University of Minnesota, Minneapolis, MN, USA
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Varaei S, Jalalian Z, Yekani Nejad MS, Shamsizadeh M. Comparison the effects of inhalation and massage aromatherapy with lavender and sweet orange on fatigue in hemodialysis patients: a randomized clinical trial. JOURNAL OF COMPLEMENTARY & INTEGRATIVE MEDICINE 2020; 18:193-200. [PMID: 32463382 DOI: 10.1515/jcim-2018-0137] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/04/2018] [Accepted: 02/19/2020] [Indexed: 11/15/2022]
Abstract
OBJECTIVES Fatigue, regardless of the causes, could leave a negative impact on individual performance. The aim of this study was to compare the effects of inhalation and massage aromatherapy with lavender and sweet orange on fatigue among hemodialysis patients. METHODS This study was a randomized controlled trial. The patients (96 patients) were allocated to three groups (control, an inhalation aromatherapy, and an aromatherapy massage group). A demographic questionnaire as well as the rhoten fatigue scale (RFS) was used to collect the data. The data were analyzed by descriptive and analytical statistics using SPSS version 18. RESULTS Before the intervention, there was no significant difference among the groups regarding fatigue level (p=0.54). However, eight and 16 weeks after the study, the levels of fatigue in both experimental groups were significantly lower than the control group (p < 0.05). CONCLUSIONS Interventions with essential oils are effective in reducing fatigue in hemodialysis patients, although the effects of aromatherapy massage on fatigue are stronger than the effects of inhalation aromatherapy.
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Affiliation(s)
- Shokoh Varaei
- ِDepartment of Medical Surgical Nursing, School of Nursing & Midwifery, Tehran University of Medical Sciences, Tehran, Iran
| | - Zahra Jalalian
- ِDepartment of Medical Surgical Nursing, School of Nursing & Midwifery, Tehran University of Medical Sciences, Tehran, Iran
| | - Mir Saeed Yekani Nejad
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Morteza Shamsizadeh
- Chronic Diseases (Home Care) Research Center, Hamadan University of Medical Sciences, Shahid Fahmideh Blvd, 6517838695, Hamadan, Iran
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Tian C, Zhang B, Liang W, Yang Q, Xiong Q, Jin Q, Xiang S, Zhao J, Ying C, Zuo X. Fatigue in Peritoneal Dialysis Patients and an Exploration of Contributing Factors: A Cross-Sectional Study. J Pain Symptom Manage 2020; 59:1074-1081.e2. [PMID: 31866487 DOI: 10.1016/j.jpainsymman.2019.12.351] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2019] [Revised: 12/10/2019] [Accepted: 12/11/2019] [Indexed: 10/25/2022]
Abstract
CONTEXT Fatigue is a common and detrimental symptom in dialysis patients; however, our understanding of it and investigation of its contributing factors is still very limited, especially in peritoneal dialysis (PD) patients. OBJECTIVES To assess fatigue in PD patients and identify contributing factors. METHODS One hundred eight PD patients in a comprehensive hospital in China were recruited. The fatigue severity of the participants was assessed using the Chalder Fatigue Scale 11. Demographic factors and results of physiological tests were collected. Quality of sleep, mental health, and social support were assessed with the Pittsburgh Sleep Quality Index, Symptom Checklist 90, and Social Support Rating Scale, respectively. Multiple linear regression models were conducted with candidate variables with a P-value of less than 0.1 on univariate analysis and variables that were clinically relevant to identify contributing factors for fatigue. RESULTS The fatigue level in PD patients was significantly higher than the community population, and 78.7% of them were suffering from fatigue. The factors that were significantly associated with fatigue were quality of sleep, normalized protein nitrogen appearance, transferrin, alkaline phosphatase, and total cholesterol (adjusted R squared 0.86). Among them, quality of sleep, transferrin, alkaline phosphatase, and total cholesterol were significant contributors for physical fatigue, whereas the quality of sleep and normalized protein nitrogen appearance were contributing factors for mental fatigue. CONCLUSION Fatigue is a common symptom in PD patients, suggesting that increased awareness of this symptom is required. The identification of correlates by extensive exploration of multidimensional factors in this study may help practitioners to identify patients at higher risk and to develop a multidimensional and targeted intervention plan.
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Affiliation(s)
- Chong Tian
- School of Nursing, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Beibei Zhang
- School of Nursing, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Wangqun Liang
- Department of Nephrology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Qing Yang
- School of Nursing, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Qianqian Xiong
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Qiman Jin
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Siyun Xiang
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Jing Zhao
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Chenjiang Ying
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Xuezhi Zuo
- Department of Clinical Nutrition, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.
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Ng MSN, Wong CL, Ho EHS, Hui YH, Miaskowski C, So WKW. Burden of living with multiple concurrent symptoms in patients with end‐stage renal disease. J Clin Nurs 2020; 29:2589-2601. [PMID: 32279368 DOI: 10.1111/jocn.15282] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2019] [Revised: 02/24/2020] [Accepted: 03/14/2020] [Indexed: 12/14/2022]
Affiliation(s)
- Marques Shek Nam Ng
- The Nethersole School of Nursing The Chinese University of Hong Kong Hong Kong China
| | - Cho Lee Wong
- The Nethersole School of Nursing The Chinese University of Hong Kong Hong Kong China
| | - Eva Hau Sim Ho
- Department of Medicine Pamela Youde Nethersole Eastern Hospital Hong Kong China
| | - Yun Ho Hui
- Nursing Services Division United Christian Hospital Hong Kong China
| | | | - Winnie Kwok Wei So
- The Nethersole School of Nursing The Chinese University of Hong Kong Hong Kong China
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11
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Dimova R, Keskinova D, Tzekov V, Ginova-Noncheva G. Health-related quality of life in end-stage renal disease patients, using the Missoula-Vitas quality of life index: a multicenter study. Med Pharm Rep 2019; 92:374-381. [PMID: 31750438 PMCID: PMC6853037 DOI: 10.15386/mpr-1320] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2019] [Revised: 06/10/2019] [Accepted: 06/25/2019] [Indexed: 11/23/2022] Open
Abstract
Background and aims Assessment of Health-related Quality of Life in chronic hemodialysis patients (CHD) is a predictive indicator of the outcome of the disease, including mortality and hospitalization. Regular surveys of the quality of life (QoL) in CHD patients have been conducted worldwide, using various, internationally validated and standardized tools, including the Missoula-VITAS Quality of Life Index scale (MVQOLI). The aim of this study was to examine the reliability and validity of the Bulgarian version of the Missoula-VITAS Quality of Life Index-15 (B-MVQOLI-15) and QoL in CHD patients using this instrument. Methods Our study was designed as multi-center cross-sectional. It incorporated 263 end-stage renal disease (ESRD) patients on CHD from across the country and applied the B-MVQOLI-15. Internal consistency and convergent validity of the index were assessed. Non-parametric methods were used to evaluate the impact of demographic factors on the different dimensions scores and on the total score. The relationship between the total QoL score, the total MVQOLI-15 score and dimensions scores were measured based on Spearman's rho Correlation Coefficient. Results The total MVQOLI-15 score in the study was 16.44, which is slightly above the middle of the index scale. The patients with higher education were less satisfied with the level of their symptom control compared to patients with lower education. However, high education patients seem to manage better with everyday life compared to those with low education. Men seem to feel more satisfied than women when fulfilling their daily activities (P=0.026). Retired patients and unemployed expressed more satisfaction, compared to the employed (P=0.021). Also, patients on dialysis for over 5 years had lower QoL scores (P=0.043). Conclusions B-MVQOLI-15 is a reliable instrument to measure QoL in Bulgarian patients with CHD. The majority of CHD patients rate their QoL as "Fair". Four of all five dimensions positively affect the QoL of CHD patients. The most important dimensions positively affecting the QoL of CHD patients were: interpersonal relationships and transcendent factors. Future studies are necessary to assess the adequacy of the delivered dialysis, the level of medico-social care and the needs of ESRD patients treated with CHD in order to improve their QoL.
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Affiliation(s)
- Rositsa Dimova
- Department of Health Management and Health Economics, Faculty of Public Health, Medical University of Plovdiv, Plovdiv, Bulgaria
| | - Donka Keskinova
- Department of Applied and Institutional Sociology, University of Plovdiv "Paisii Hilendarski", Plovdiv, Bulgaria
| | - Valeri Tzekov
- 2 Department of Internal Diseases, Faculty of Medicine, Medical University of Plovdiv, Plovdiv, Bulgaria
| | - Gergana Ginova-Noncheva
- 2 Department of Internal Diseases, Faculty of Medicine, Medical University of Plovdiv, Plovdiv, Bulgaria
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Zyga S, Alikari V, Sachlas A, Fradelos EC, Stathoulis J, Panoutsopoulos G, Georgopoulou M, Theophilou P, Lavdaniti M. Assessment of Fatigue in End Stage Renal Disease Patients Undergoing Hemodialysis: Prevalence and Associated Factors. Med Arch 2018; 69:376-80. [PMID: 26843728 PMCID: PMC4720468 DOI: 10.5455/medarh.2015.69.376-380] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Background: Fatigue is a common symptom referred by many patients undergoing hemodialysis. Fatigue is associated with poor health-related quality of life (HRQoL) and is an important predictor for survival of hemodialysis patients. Aim: To assess the levels of fatigue and demographic factors affecting it among patients with End Stage Renal Disease undergoing hemodialysis. Methods: This quantitative study was carried out in two Dialysis Units of Hospitals in Athens Region. Between January 2015 and June 2015, 129 hemodialysis patients completed the Greek Version of the Fatigue Assessment Scale (FAS). Demographic data of patients was recorded. For the statistical analysis IBM SPSS Statistics version 20 was used. Results: The mean FAS score was 24.99. 49 patients (38.0%) were non fatigued, 61 patients (47.3%) were fatigued, and 19 patients (13.7%) were extremely fatigued. Higher levels of fatigue were reported among hemodialysis patients residing in urban areas, in those with low educational level and unemployed. Conclusion: The findings of this study can be used in the assessment of fatigue and early identification of high-risk patients (especially of the unemployed, those who occupy with domestic works, those with low educational level and of urban citizens). Use of this knowledge by hemodialysis nurses may lead to a better understanding of the factors of fatigue in ESRD, which in turn may lead to a more effective treatment.
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Affiliation(s)
- Sofia Zyga
- Department of Nursing, Faculty of Human Movement and Quality of Life Sciences, University of Peloponnese, Sparta, Lakonia, Greece
| | - Victoria Alikari
- Department of Nursing, Faculty of Human Movement and Quality of Life Sciences, University of Peloponnese, Sparta, Lakonia, Greece
| | - Athanasios Sachlas
- Department of Nursing, Faculty of Human Movement and Quality of Life Sciences, University of Peloponnese, Sparta, Lakonia, Greece
| | - Evangelos C Fradelos
- Department of Nursing, Faculty of Human Movement and Quality of Life Sciences, University of Peloponnese, Sparta, Lakonia, Greece
| | - John Stathoulis
- Department of Nursing, Faculty of Human Movement and Quality of Life Sciences, University of Peloponnese, Sparta, Lakonia, Greece
| | - Georgios Panoutsopoulos
- Department of Nursing, Faculty of Human Movement and Quality of Life Sciences, University of Peloponnese, Sparta, Lakonia, Greece
| | | | | | - Maria Lavdaniti
- Department of Nursing, Technological educational institute of Thessaloniki, Thessaloniki, Greece
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13
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Kim ES. Development and effect of a rational-emotive-behaviour-therapy-based self-management programme for early renal dialysis patients. J Clin Nurs 2018; 27:4179-4191. [PMID: 29968272 DOI: 10.1111/jocn.14608] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2017] [Revised: 05/09/2018] [Accepted: 06/25/2018] [Indexed: 11/28/2022]
Abstract
AIMS AND OBJECTIVES This study attempts to develop and determine the effect a rational-emotive-behaviour-therapy-based self-management programme can have on the self-efficacy, self-care, depression and dyssomnia of patients undergoing early renal dialysis. BACKGROUND When renal dialysis is initiated, changes in everyday life are inevitable, and patients can suffer from both psychological and physical symptoms. Hence, to obtain the best results from renal dialysis, active self-management is required. DESIGN Quasi-experimental and longitudinal. METHODS Forty-eight early-stage renal dialysis patients registered for and undergoing renal dialysis at a hospital located in S city participated in this study. These individuals were divided into an experimental and control group. The former group engaged in a self-management programme consisting of eight weekly sessions of 50 min in duration, while the latter received traditional nursing care. Data were collected from June 2012-May 2014 through the use of a preliminary survey, a postsurvey that was distributed after the eight sessions of the self-management programme had been completed, and a follow-up survey allocated 4 weeks after the postsurvey. Data collection was conducted using the Self-efficacy Scale, Self-care Practice Scale, Beck Depression Inventory, and Korean Sleep Scale, and a repeated-measures ANOVA was used to perform analysis. RESULTS The experimental group significantly differed from the control group in regard to self-efficacy (p = 0.006) and self-care (p = 0.031), but differences in terms of depression (p = 0.492) and dyssomnia (p = 0.141) were nonsignificant. In the experimental group, the depression decreased but then increased again, while the dyssomnia gradually decreased. CONCLUSIONS The provision of a rational-emotive-behaviour-therapy-based self-management programme that involves lectures, discussions, teach-backs, demonstrations and posters explaining diet choices improves the self-efficacy and self-care of patients receiving renal dialysis. RELEVANCE TO CLINICAL PRACTICE Rational-emotive-behaviour-therapy-based self-management programmes can be used in clinical nursing sites to improve the self-efficacy and self-care of early renal dialysis patients.
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Affiliation(s)
- Eun Sook Kim
- Department of Nursing, College of Health Sciences, Cheongju University, Cheongju, Chungbuk, Korea
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14
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Tchape ODM, Tchapoga YB, Atuhaire C, Priebe G, Cumber SN. Physiological and psychosocial stressors among hemodialysis patients in the Buea Regional Hospital, Cameroon. Pan Afr Med J 2018; 30:49. [PMID: 30197740 PMCID: PMC6125286 DOI: 10.11604/pamj.2018.30.49.15180] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2018] [Accepted: 05/12/2018] [Indexed: 12/11/2022] Open
Abstract
INTRODUCTION End Stage Renal Disease (ESRD) is an irreversible kidney condition and hemodialysis is the most frequent treatment option used for this condition. However, hemodialysis also has a detrimental impact on the quality of life and the individuals' physical and psychosocial wellbeing. The main objective of this study was to identify physiological and psychosocial stressors faced by patients undergoing hemodialysis in the Buea Regional Hospital in Cameroon. METHODS A cross-sectional study was carried out (December 2016 - January 2017) among patients undergoing hemodialysis at the Buea regional hospital. Data were collected with the use of a structured questionnaire and analyzed using SPSS version 21.0. Quantitative variables were expressed as frequencies, percentages and means. RESULTS Among the patients undergoing hemodialysis, 28 (70.0%) were below 5-year dialysis while 12 (30.0%) had been on dialysis for five years and more. 21(52.5%) were male and 19(47.5%) female. Half of the patients were married 20(50%), 13(32.5%) were single, 6(15%) were divorced, and one (2.5%) was a widower. Also, 28 (70.0%) were below 5-year dialysis while 12 (30.0%) had been on dialysis for five years and more. All participants experienced at least one or more physiological and psychosocial stressors. Among physiological stressors, the most frequent were feeling tired (97%), followed by arterial and venous stick (88%) while itching (49.5%) was the least noted physiological stressor. Among psycho-social stressors, the most recurrent were transportation to and from the hospital (99.5%), cost of treatment (99.5%) and Limits on time and place of vacation (99%), followed by Limitation in physical activities, frequent hospitalizations, the length of time on dialysis, uncertainty about the future, changes in life style, increased dependence and sleep disturbances. CONCLUSION The topic of stressors is of importance among patients receiving dialysis, as these affect their psycho-social and physiological wellbeing. Thus, nephrologists, nurses and family members play an important role in providing patients with effective psycho-social and physiological support.
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Affiliation(s)
| | | | - Catherine Atuhaire
- Faculty of Medicine, Department of Nursing, Mbarara University of Science and Technology, Uganda
| | - Gunilla Priebe
- Section for Epidemiology and Social Medicine, Department of Public Health, Institute of Medicine (EPSO), The Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
| | - Samuel Nambile Cumber
- Section for Epidemiology and Social Medicine, Department of Public Health, Institute of Medicine (EPSO), The Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
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15
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Das M, Angeli F, Krumeich AJSM, van Schayck OCP. Patterns of illness disclosure among Indian slum dwellers: a qualitative study. BMC INTERNATIONAL HEALTH AND HUMAN RIGHTS 2018; 18:3. [PMID: 29338708 PMCID: PMC5771001 DOI: 10.1186/s12914-018-0142-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/27/2017] [Accepted: 01/03/2018] [Indexed: 11/30/2022]
Abstract
BACKGROUND Slum dwellers display specific traits when it comes to disclosing their illnesses to professionals. The resulting actions lead to poor health-seeking behaviour and underutilisation of existing formal health facilities. The ways that slum people use to communicate their feelings about illness, the type of confidants that they choose, and the supportive and unsupportive social and cultural interactions to which they are exposed have not yet been studied in the Indian context, which constitutes an important knowledge gap for Indian policymakers and practitioners alike. To that end, this study examines the patterns of illness disclosure in Indian slums and the underpinning factors which shape the slum dwellers' disclosing attitude. METHODS In-depth, semi-structured interviews were conducted among 105 men and 113 women who experienced illness in the year prior to the study period. Respondents were selected from four urban slums in two Indian cities, Bangalore and Kolkata. RESULTS Findings indicate that women have more confidants at different social levels, while men have a limited network of disclosures which is culturally and socially mediated. Gender role limitations, exclusion from peer groups and unsupportive local situations are the major cause of disclosure delay or non-disclosure among men, while the main concerns for women are a lack of proper knowledge about illness, unsupportive responses received from other people on certain occasions, the fear of social stigma, material loss and the burden of the local situation. Prompt sharing of illness among men is linked with prevention intention and coping with biological problems, whereas factors determining disclosure for women relate to ensuring emotional and instrumental safety, preventing collateral damage of illness, and preventing and managing biological complications. CONCLUSIONS The findings reveal that patterns of disclosure are not determined by the acknowledgment of illness but largely depend on the interplay between individual agency, disclosure consequences and the socio cultural environment. The results of this study can contribute significantly to mitigating the pivotal knowledge gap between health policymakers, practitioners and patients, leading to the formulation of policies that maximise the utilisation of health facilities in slums.
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Affiliation(s)
- Moumita Das
- School for Public Health and Primary Care, Maastricht University, Maastricht, the Netherlands
- Institute for Social and Economic Change (ISEC), Bangalore, India
| | - Federica Angeli
- Department of Organization Studies, School of Social and Behavioral Sciences, Tilburg University, Tilburg, the Netherlands
| | - Anja J. S. M. Krumeich
- Department of Health Ethics and Society, School for Public Health and Primary Care, Maastricht University, Maastricht, the Netherlands
| | - Onno C. P. van Schayck
- Department of General Practice, School for Public Health and Primary Care, Maastricht University, Maastricht, the Netherlands
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Eslami AA, Rabiei L, Shirani M, Masoudi R. Dedication in Caring of Hemodialysis Patients: Perspectives and Experiences of Iranian Family Caregivers. Indian J Palliat Care 2018; 24:486-490. [PMID: 30410262 PMCID: PMC6199822 DOI: 10.4103/ijpc.ijpc_204_17] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Background: Although dialysis treatment is considered as a life-saving treatment for chronic renal failure patients, the caregivers face challenges in caretaking of these patients. Objectives: This study is aimed to explain the perspectives and experiences among caregivers of the patients undergoing hemodialysis in Iran. Methods: A qualitative design, based on a thematic analysis approach, was used to reach the study aim. In this study, 25 hemodialysis family caregivers were selected by purposeful sampling. The data were gathered through in-depth and unstructured interview and field observation and analyzed by the inductive thematic approach. Results: The three main themes were generated from the analysis of the data indicating that the caregivers face challenges such as heavy burden of care, tension in care, and emotional exhaustion. Conclusion: Caretaking of the hemodialysis patients is constantly accompanied with challenges and concerns regarding the effective care for patients. Health-care providers need to address these concerns based on both patient- and caregiver-focused approaches, rather than only patient focused, to the design and planning for helping the patients and their caregivers.
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Affiliation(s)
- Ahmad Ali Eslami
- Department of Health Education and Promotion, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Leili Rabiei
- Department of Health Education and Promotion, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Majid Shirani
- Department of Urology, School of Medicine, Shahrekord University of Medical Sciences, Shahrekord, Iran
| | - Reza Masoudi
- Community-Oriented Nursing Midwifery Research Center, Shahrekord University of Medical Sciences, Shahrekord, Iran
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17
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Sutcliffe BK, Bennett PN, Fraser SF, Mohebbi M. The deterioration in physical function of hemodialysis patients. Hemodial Int 2017; 22:245-253. [DOI: 10.1111/hdi.12570] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Brianna K. Sutcliffe
- Institute for Physical Activity and Nutrition; School of Exercise and Nutrition Sciences, Faculty of Health, Deakin University; Geelong Victoria Australia
| | - Paul N. Bennett
- School of Nursing and Midwifery, Faculty of Health; Deakin University; Geelong Victoria Australia
- Satellite Healthcare; San Jose California USA
| | - Steve F. Fraser
- Institute for Physical Activity and Nutrition; School of Exercise and Nutrition Sciences, Faculty of Health, Deakin University; Geelong Victoria Australia
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18
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Farragher JF, Polatajko HJ, Jassal SV. The Relationship Between Fatigue and Depression in Adults With End-Stage Renal Disease on Chronic In-Hospital Hemodialysis: A Scoping Review. J Pain Symptom Manage 2017; 53:783-803.e1. [PMID: 28042060 DOI: 10.1016/j.jpainsymman.2016.10.365] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2016] [Revised: 10/11/2016] [Accepted: 10/24/2016] [Indexed: 11/23/2022]
Abstract
CONTEXT Fatigue and depression are two prominent concerns in patients on in-hospital hemodialysis (IHHD) that have recently been identified as research priorities in the nephrology community. Although they are often reported to co-exist, no synthesis of the literature examining their relationship is available. OBJECTIVE The aim of this study was to characterize the literature on the relationship between fatigue and depression in IHHD patients. METHODS A scoping review as described by Arksey and O'Malley was conducted. Seven electronic databases were searched for relevant literature using search terms pertaining to fatigue, depression, and IHHD. Key journals and article reference lists were also hand searched to identify relevant literature. Articles were examined for relevance, and data were extracted to describe the nature and scope of the literature and to characterize the relationship between fatigue and depression. Findings were grouped thematically and summarized descriptively. RESULTS AND CONCLUSIONS Current literature on this topic is dominated by cross-sectional studies, which support the existence of an association between fatigue and depression in IHHD patients in various practice settings and subpopulations. Numerous multivariable analyses have been performed which suggest the association remains after adjustment for confounding factors. However, there is generally a dearth of longitudinal or interventional literature to clarify the nature of the relationship over time. Current literature is sufficient to justify routine screening for depression in IHHD patients who present with fatigue. Future research should aim to clarify the nature of the relationship over time in IHHD patients, explore mediators and modifiers of the relationship, and investigate the effects of interventions.
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Affiliation(s)
- Janine F Farragher
- Division of Nephrology, University Health Network, Toronto, Canada; Rehabilitation Sciences Institute, Faculty of Medicine, University of Toronto, Toronto, Canada.
| | - Helene J Polatajko
- Rehabilitation Sciences Institute, Faculty of Medicine, University of Toronto, Toronto, Canada
| | - Sarbjit V Jassal
- Division of Nephrology, University Health Network, Toronto, Canada; Faculty of Medicine, University of Toronto, Toronto, Canada
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Picariello F, Moss-Morris R, Macdougall IC, Chilcot AJ. The role of psychological factors in fatigue among end-stage kidney disease patients: a critical review. Clin Kidney J 2016. [PMID: 28638608 PMCID: PMC5469558 DOI: 10.1093/ckj/sfw113] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Fatigue is a common and debilitating symptom, affecting 42-89% of end-stage kidney disease patients, persisting even in pre-dialysis care and stable kidney transplantation, with huge repercussions on functioning, quality of life and patient outcomes. This paper presents a critical review of current evidence for the role of psychological factors in renal fatigue. To date, research has concentrated primarily on the contribution of depression, anxiety and subjective sleep quality to the experience of fatigue. These factors display consistent and strong associations with fatigue, above and beyond the role of demographic and clinical factors. Considerably less research is available on other psychological factors, such as social support, stress, self-efficacy, illness and fatigue-specific beliefs and behaviours, and among transplant recipients and patients in pre-dialysis care. Promising evidence is available on the contribution of illness beliefs and behaviours to the experience of fatigue and there is some indication that these factors may vary according to treatment modality, reflecting the differential burdens and coping necessities associated with each treatment modality. However, the use of generic fatigue scales casts doubt on what specifically is being measured among dialysis patients, illness-related fatigue or post-dialysis-specific fatigue. Therefore, it is important to corroborate the available evidence and further explore, qualitatively and quantitatively, the differences in fatigues and fatigue-specific beliefs and behaviours according to renal replacement therapy, to ensure that any model and subsequent intervention is relevant and grounded in the experiences of patients.
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Affiliation(s)
- Federica Picariello
- Health Psychology Section, Psychology Department, Institute of Psychiatry, Psychology, & Neuroscience, King's College London, London, UK
| | - Rona Moss-Morris
- Health Psychology Section, Psychology Department, Institute of Psychiatry, Psychology, & Neuroscience, King's College London, London, UK
| | | | - And Joseph Chilcot
- Health Psychology Section, Psychology Department, Institute of Psychiatry, Psychology, & Neuroscience, King's College London, London, 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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Cha SM, Min HS. The Effect of Dialysate Flow Rate on Dialysis Adequacy and Fatigue in Hemodialysis Patients. J Korean Acad Nurs 2016; 46:642-652. [DOI: 10.4040/jkan.2016.46.5.642] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2016] [Revised: 05/04/2016] [Accepted: 05/17/2016] [Indexed: 11/09/2022]
Affiliation(s)
- Sun Mi Cha
- Artificial Kidney Unit, Bethesda Hospital, Yangsan, Korea
| | - Hye Sook Min
- Department of Nursing, Dong-A University, Busan, Korea
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22
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Maniam R, Subramanian P, Singh SKS, Lim SK, Chinna K, Rosli R. Preliminary study of an exercise programme for reducing fatigue and improving sleep among long-term haemodialysis patients. Singapore Med J 2015; 55:476-82. [PMID: 25273932 DOI: 10.11622/smedj.2014119] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
INTRODUCTION Fatigue and quality of sleep are the main factors that contribute to a poor quality of life among patients on long-term haemodialysis. Studies have also emphasised the importance of exercise for improving the wellbeing of dialysis patients. This study aimed to determine the effectiveness of a predialysis low-to-moderate-intensity exercise programme for reducing fatigue and improving sleep disorders among long-term haemodialysis patients. METHODS In this quasi-experimental study, an exercise programme was conducted three times a week for 12 weeks before long-term haemodialysis patients underwent dialysis at two centres. The patients were categorised into either the exercise group (n = 28) or control group (n = 27). The latter was asked to maintain their current lifestyles. Assessments of fatigue and sleep disorder levels were performed for both groups using self-reported questionnaires at baseline and after intervention. The patients' perception of the exercise programme was also determined using self-reported questionnaires. RESULTS Paired sample t-test indicated improvements in fatigue level in the exercise group (mean fatigue score: post-treatment 40.5 ± 7.9 vs. pre-treatment 30.0 ± 10.9). Improvements in sleep disorders were also observed in the exercise group (mean score: post-treatment 7.6 ± 3.3 vs. pre-treatment 10.1 ± 3.8). However, sleep quality deteriorated in the control group (mean score: post-treatment 10.7 ± 2.9 vs. pre-treatment 9.3 ± 2.9). CONCLUSION Simple low-to-moderate-intensity exercise is effective for improving fatigue, sleep disorders and the overall quality of life among haemodialysis patients.
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Affiliation(s)
| | - Pathmawathi Subramanian
- Department of Nursing Science, Faculty of Medicine, University of Malaya, 50603 Kuala Lumpur, Malaysia.
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Psychosocial and Clinical Correlates of Fatigue in Haemodialysis Patients: the Importance of Patients’ Illness Cognitions and Behaviours. Int J Behav Med 2015; 23:271-281. [DOI: 10.1007/s12529-015-9525-8] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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Shahgholian N, Yousefi H. Supporting hemodialysis patients: A phenomenological study. IRANIAN JOURNAL OF NURSING AND MIDWIFERY RESEARCH 2015; 20:626-33. [PMID: 26457103 PMCID: PMC4598912 DOI: 10.4103/1735-9066.164514] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BACKGROUND Chronic renal disease and hemodialysis cause numerous psychological, social, cultural, and spiritual challenges for both patients and their families. Overcoming these challenges is possible only through providing holistic support for the patients. Today, despite the support provided by family and professional caregivers for the patients, patients still express dissatisfaction with the support provided and believe it to be inadequate. In fact, patients and family caregivers and healthcare practitioners seem to have different understandings of the notion of support. Thus, the researcher decided to examine the concept of support from the viewpoint of hemodialysis patients. MATERIALS AND METHODS This descriptive phenomenological research was conducted on 17 patients with end-stage renal disease (ESRD) who were undergoing hemodialysis. Purposive sampling was performed and continued until data saturation. Data were collected through 30-60 min unstructured interviews and analyzed using Colaizzi's method. RESULTS From the analysis of data, 4 themes (psychological support, accompaniment, social support, and spiritual support) and 11 sub-themes were obtained. Psychological support consisted of two sub-themes of psychological support by healthcare practitioners and emotional support by family and relatives. Accompaniment included three sub-themes of assistance in transportation, providing and using medicine, and daily activities. Social support was identified with four sub-themes of promotion of the society's understanding of the patients' condition, improvement of communication with others, the need for employment, and independence. Spiritual support was identified with two sub-themes of the need for faith and trust in God or Imams and the need to resolve spiritual contradictions. CONCLUSION The results showed that from the viewpoint of the participants, the concept of support consisted of psychological support, social support, accompanying the patient, and spiritual support. Hence, it can be concluded that this concept should be considered in healthcare planning, in order to improve the health and quality of life of these patients and their adaptation to the disease and its treatment process.
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Affiliation(s)
- Nahid Shahgholian
- Department of Critical Care Nursing, Kidney Diseases Research Center, Faculty of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Hojatollah Yousefi
- Department of Adult Nursing, Faculty of Nursing and Midwifery, Nursing and Midwifery Care Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
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Magnard J, Lardy J, Testa A, Hristea D, Deschamps T. The effect of hemodialysis session on postural strategies in older end-stage renal disease patients. Hemodial Int 2015; 19:553-61. [DOI: 10.1111/hdi.12307] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Justine Magnard
- Laboratory “Motricité, Interactions, Performance” (UPRES EA 4334); University of Nantes; Nantes France
| | - Julien Lardy
- Laboratory “Motricité, Interactions, Performance” (UPRES EA 4334); University of Nantes; Nantes France
| | - Angelo Testa
- Dialysis Unit; ECHO Nantes Dialysis Association; Nantes France
| | - Dan Hristea
- Dialysis Unit; ECHO Nantes Dialysis Association; Nantes France
| | - Thibault Deschamps
- Laboratory “Motricité, Interactions, Performance” (UPRES EA 4334); University of Nantes; Nantes France
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Bai YL, Lai LY, Lee BO, Chang YY, Chiou CP. The impact of depression on fatigue in patients with haemodialysis: a correlational study. J Clin Nurs 2015; 24:2014-22. [PMID: 25827047 DOI: 10.1111/jocn.12804] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/26/2015] [Indexed: 12/20/2022]
Abstract
AIMS AND OBJECTIVES To investigate the fatigue levels and important fatigue predictors for patients undergoing haemodialysis. BACKGROUND Fatigue is a common symptom for haemodialysis patients. With its debilitating and distressing effects, it impacts patients in terms of their quality of life while also increasing their mortality rate. DESIGN A descriptive correlational study. METHODS Convenience sampling was conducted at six chosen haemodialysis centres in Southern Taiwan. Data were collected via a structured questionnaire from 193 haemodialysis patients. The scales involved in this study were socio-demographic details, the Center for Epidemiologic Studies Depression Scale, and the Fatigue Scale for haemodialysis patients. Data analysis included percentages, means, standard deviations and hierarchical multiple regression analysis. RESULTS The fatigue level for haemodialysis patients was in the moderate range. Results from the hierarchical multiple regression analysis indicated that age, employment status, types of medications, physical activity and depression were significant. Of those variables, depression had the greatest impact on the patients' fatigue level, accounting for up to 30·6% of the explanatory power. The total explanatory power of the regression model was 64·2%. CONCLUSION This study determined that for haemodialysis patients, unemployment, increased age, taking more medications or lower exercise frequencies resulted in more severe depression, which translated in turn to higher levels of fatigue. Among all these factors, depression had the greatest impact on the patients' fatigue levels. RELEVANCE TO CLINICAL PRACTICE Not only is this finding beneficial to future studies on fatigue as a source of reference, it is also helpful in our understanding of important predictors relating to fatigue in the everyday lives of haemodialysis patients. It is recommended that when caring for fatigued patients, more care should be dedicated to their psychological states, and assistance should be provided in a timely way so as to reduce the amount of fatigue suffered.
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Affiliation(s)
- Yu-Ling Bai
- Department of Nursing, Chung Hwa University of Medical Technology, Tainan, Taiwan
| | - Liu-Yuan Lai
- Department of Nursing, Fooyin University Hospital, Pingtung, Taiwan
| | - Bih-O Lee
- Department of Nursing, Chang Gung University of Science and Technology, Chia-Yi, Taiwan
| | - Yong-Yuan Chang
- Department of Healthcare Administration and Medical Informatics, Kaohsiung Medical University, Kaohsiung, Taiwan
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Artom M, Moss-Morris R, Caskey F, Chilcot J. Fatigue in advanced kidney disease. Kidney Int 2014; 86:497-505. [DOI: 10.1038/ki.2014.86] [Citation(s) in RCA: 109] [Impact Index Per Article: 10.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2013] [Revised: 12/10/2013] [Accepted: 01/09/2014] [Indexed: 01/14/2023]
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Motedayen Z, Nehrir B, Tayebi A, Ebadi A, Einollahi B. The effect of the physical and mental exercises during hemodialysis on fatigue: a controlled clinical trial. Nephrourol Mon 2014; 6:e14686. [PMID: 25695018 PMCID: PMC4317722 DOI: 10.5812/numonthly.14686] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2013] [Revised: 10/16/2013] [Accepted: 10/20/2013] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Despite regular treatment by hemodialysis, patients on hemodialysis are affected by uremic syndrome, which is marked by fatigue. Fatigue is supposed as the most common and the most severe symptom ever reported by patients with chronic kidney disease. OBJECTIVES This controlled study aimed to evaluate the effect of intradialytic physical and mental exercises on fatigue in patients on hemodialysis. PATIENTS AND METHODS A total of 66 patients on long-term hemodialysis were selected via purposive sampling and were assigned to two groups, namely, control and experimental groups. The experimental group participated in a intradialytic training program twice a week for two months. The program was designed by a senior expert in physical education. Their fatigue was measured via a fatigue severity scale questionnaire before as well as one and two months after the intervention in both groups. RESULTS The mean of the fatigue score within the research units was 42.37. Overall, 42.2% and 56.1% of the participants experienced medium and severe fatigue, respectively. The scores of fatigue decreased significantly from the beginning through two months after intervention in the experiment group. CONCLUSIONS With respect to the findings of the study, this method of treatment is recommended due to being cost efficient, easy, applicable, and flexible for alleviating the effect of fatigue on the personal, psychological, and social aspects of life quality in patients on hemodialysis.
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Affiliation(s)
- Zeynab Motedayen
- Nephrology and Urology Research Center, Baqiyatallah University of Medical Sciences, Tehran, IR Iran
- School of Nursing, Baqiyatallah University of Medical Sciences, Tehran, IR Iran
| | - Batool Nehrir
- School of Nursing, Baqiyatallah University of Medical Sciences, Tehran, IR Iran
- Corresponding author: Batool Nehrir, School of Nursing, Baqiyatallah University of Medical Sciences, Tehran, IR Iran. Tel: +98-9125104094, Fax: +98-2126127237, E-mail:
| | - Ali Tayebi
- School of Nursing, Baqiyatallah University of Medical Sciences, Tehran, IR Iran
| | - Abbas Ebadi
- School of Nursing, Baqiyatallah University of Medical Sciences, Tehran, IR Iran
| | - Behzad Einollahi
- Nephrology and Urology Research Center, Baqiyatallah University of Medical Sciences, Tehran, IR Iran
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Biniaz V, Sadeghi Shermeh M, Ebadi A, Tayebi A, Einollahi B. Effect of Vitamin C Supplementation on C-reactive Protein Levels in Patients Undergoing Hemodialysis: A Randomized, Double Blind, Placebo-Controlled Study. Nephrourol Mon 2013; 6:e13351. [PMID: 24719806 PMCID: PMC3968960 DOI: 10.5812/numonthly.13351] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2013] [Revised: 07/14/2013] [Accepted: 08/03/2013] [Indexed: 02/07/2023] Open
Abstract
Background: Chronic inflammation is the most important cause of cardiovascular disease in patients undergoing hemodialysis, and vitamin C as a major antioxidant which could be effective to suppress inflammation. Objectives: This study was performed to evaluate the effect of vitamin C supplementation on C-reactive protein levels in patients undergoing hemodialysis. Patients and Methods: This randomized, placebo-controlled and double-blind trial was conducted on 151 patients on hemodialysis who were divided randomly by lottery method to three identical groups. In the intervention group, 250 mg of vitamin C was injected intravenously immediately at the end of each hemodialysis session three times a week for 8 weeks in a row. In the control group 1, same term of placebo saline was injected, and in the control group 2, no intervention was performed. Results: A total of 86 (61%) male and 55 female patients with mean hemodialysis duration of 39.74 ± 45.5 months, and a mean age of 61.36 ± 11.46 years-old, participated in this study. Hypertension and diabetes were the most common underlying diseases (79.4%). Median baseline CRP in the intervention, control 1 and control 2 groups were 16.8, 17.8, and 19.4 mg/L respectively. After 2 months, median CRP reduced significantly in the vitamin C group to 10.7 (P = 0.04) vs. 22.6, and 30.6 mg/L in control groups. Conclusions: Our findings demonstrated that vitamin C supplementation modifies the levels of CRP in patients on hemodialysis.
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Affiliation(s)
- Vajihe Biniaz
- Nephrology and Urology Research Center, Baqiyatallah University of Medical Sciences, Tehran, IR Iran
| | - Mehdi Sadeghi Shermeh
- Department of Medical Surgical Nursing, Baqiyatallah University of Medical Sciences, Tehran, IR Iran
| | - Abbas Ebadi
- Department of Medical Surgical Nursing, Baqiyatallah University of Medical Sciences, Tehran, IR Iran
| | - Ali Tayebi
- Department of Medical Surgical Nursing, Baqiyatallah University of Medical Sciences, Tehran, IR Iran
- Corresponding author: Ali Tayebi, Department of Medical Surgical Nursing, Baqiyatallah University of Medical Sciences, Tehran, IR Iran. Tel: +98-9121058516, Fax: +98-2126127253, E-mail:
| | - Behzad Einollahi
- Nephrology and Urology Research Center, Baqiyatallah University of Medical Sciences, Tehran, IR Iran
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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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Karadag E, Kilic SP, Metin O. Relationship between fatigue and social support in hemodialysis patients. Nurs Health Sci 2013; 15:164-71. [DOI: 10.1111/nhs.12008] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2012] [Revised: 09/14/2012] [Accepted: 09/21/2012] [Indexed: 12/11/2022]
Affiliation(s)
- Ezgi Karadag
- Department of Internal Medicine Nursing; Tunceli University Health High School; Tunceli
| | - Serap Parlar Kilic
- Department of Internal Medicine Nursing; Gaziantep University Faculty of Health Sciences; Gaziantep
| | - Ozgur Metin
- Turgut Özal Tıp Merkezi; Malatya Inonu University; Malatya; Turkey
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32
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Affiliation(s)
- Daniel Cukor
- Department of Psychiatry, SUNY Downstate Medical Center, Brooklyn, New York 11203-2098, USA.
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Lukkahatai N, Saligan LN. Association of catastrophizing and fatigue: a systematic review. J Psychosom Res 2013; 74:100-9. [PMID: 23332523 PMCID: PMC3553502 DOI: 10.1016/j.jpsychores.2012.11.006] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2012] [Revised: 11/05/2012] [Accepted: 11/08/2012] [Indexed: 10/27/2022]
Abstract
OBJECTIVE Catastrophizing is an exaggerated negative evaluation and attention to specific symptoms such as pain or fatigue. A number of studies consistently support the significant role of catastrophizing in pain. However, the role of catastrophizing in fatigue is less frequently investigated. This article provides a critical review of published studies investigating this association. METHODS Using the keyword "Fatigue AND Catastrophizing", we performed a search in PubMed, SCOPUS, PsycINFO, and EMBASE. RESULTS Fourteen studies were reviewed and all except one were found to provide empirical support for an association between high catastrophizing and high fatigue. Most of these reviewed articles also show the large impact of catastrophizing on fatigue severity. Two longitudinal studies found that fatigue catastrophizing level before cancer treatment is a significant predictor of post-treatment fatigue. Studies also demonstrated that persons who had higher scores for catastrophizing recalled fatigue more accurately than those with lower scores. CONCLUSION In spite the differences of its definition and the measurements used, a similar significant association between catastrophizing and fatigue was reported. Because this observation was based on 14 studies with limited types of patients, further studies are recommended to examine the role of catastrophizing in fatigue from other clinical populations and to investigate its utility as a behavioral marker for central fatigue.
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Affiliation(s)
- Nada Lukkahatai
- National Institute of Nursing Research, National Institutes of Health, Bethesda, MD 20892, USA.
| | - Leorey N. Saligan
- National Institute of Nursing Research, National Institutes of Health, Bethesda, Maryland, USA
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Horigan AE. Fatigue in hemodialysis patients: a review of current knowledge. J Pain Symptom Manage 2012; 44:715-24. [PMID: 22743156 DOI: 10.1016/j.jpainsymman.2011.10.015] [Citation(s) in RCA: 61] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2011] [Revised: 10/27/2011] [Accepted: 11/01/2011] [Indexed: 10/28/2022]
Abstract
CONTEXT End-stage renal disease is a common chronic illness increasing in incidence and prevalence. Although kidney function is partially replaced through dialysis, patients endure many symptoms of the disease such as fatigue. Many factors have been studied regarding their relationship with fatigue in this population. OBJECTIVES To provide a state of the science review regarding fatigue in hemodialysis patients by examining the experience of fatigue for patients on hemodialysis and correlates of fatigue in patients on hemodialysis. METHODS PubMed, the Cumulative Index to Nursing and Allied Health Literature, PsycINFO, and Sociological Abstracts were searched using the key terms "fatigue," "dialysis," and "hemodialysis." Articles written after 1980 and those with explicit findings related to fatigue were included in this review. Articles that discussed fatigue in peritoneal dialysis patients or renal transplant patients were not included. RESULTS There is little knowledge regarding the experience of fatigue for patients on hemodialysis and there has been little success identifying demographic, psychosocial, or physiological factors that are consistently related to fatigue. CONCLUSION Further work in this area of inquiry would be of benefit and may shed light on the domains of life that are affected by fatigue for hemodialysis patients. It also may help deepen our knowledge regarding correlates that could identify hemodialysis patients who are at increased risk for fatigue.
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Affiliation(s)
- Ann E Horigan
- Duke University School of Nursing, Durham, NC 27710, USA.
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35
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Cho MK. Effect of health contract intervention on renal dialysis patients in Korea. Nurs Health Sci 2012; 15:86-93. [PMID: 23107436 DOI: 10.1111/nhs.12003] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2012] [Revised: 08/07/2012] [Accepted: 08/25/2012] [Indexed: 11/28/2022]
Abstract
This study is a randomized, controlled trial to examine the effect of the health contract intervention, based on the goal attainment theory, on the self-care behavior and physiological indices of renal dialysis patients in Korea. The experimental group (n = 21) underwent health contract intervention for 4 weeks, while the control group (n = 22) received routine care. The data were collected using questionnaires and measurement of physiological indices and analyzed using the SPSS WIN 12.0 program. A P value < 0.05 was considered statistically significant. Total score of self-care behavior (P = 0.011) and individual scores for behaviors, such as diet (P = 0.017), exercise and rest (P = 0.001), and blood pressure and body weight (P = 0.006) were higher in the experimental group. Serum potassium concentration and mean weight gain between dialysis sessions were significantly low in the experimental group (P = 0.002, P = 0.017). Therefore, the health contract intervention based on the goal attainment theory proved effective in improving self-care behavior and physiological indices (K, P, mean weight gain) in renal dialysis patients in Korea.
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Affiliation(s)
- Mi-Kyoung Cho
- College of Nursing, Eulji University, Seongnam-si, Korea.
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Sakkas GK, Karatzaferi C. Hemodialysis fatigue: just "simple" fatigue or a syndrome on its own right? Front Physiol 2012; 3:306. [PMID: 22934057 PMCID: PMC3429077 DOI: 10.3389/fphys.2012.00306] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2012] [Accepted: 07/12/2012] [Indexed: 11/13/2022] Open
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Abstract
Fatigue is common in chronic hemodialysis (HD) patients and impacts on daily living, impairs significantly the quality of life, increases the risk of cardiovascular events and negatively influences survival. Although numerous social, demographic, clinical, and laboratory variables have been associated with fatigue, the causes of this symptom are often unclear. In the absence of an underlying, treatable disorder, the results of therapeutic intervention are typically frustrating. So far, none of the drugs tested can be recommended for preventing and treating fatigue in chronic HD patients. There is some evidence that exercise may significantly improve fatigue in dialysis patients; however, this requires confirmation through large, prospective, randomized studies.
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Affiliation(s)
- Maurizio Bossola
- Hemodialysis Service, Department of Surgery, Catholic University, Rome, Italy.
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