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Erickson SJ, Yabes JG, Han Z, Roumelioti ME, Rollman BL, Weisbord SD, Steel JL, Unruh ML, Jhamb M. Associations between Social Support and Patient-Reported Outcomes in Patients Receiving Hemodialysis: Results from the TACcare Study. KIDNEY360 2024; 5:860-869. [PMID: 38704664 PMCID: PMC11219113 DOI: 10.34067/kid.0000000000000456] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Accepted: 04/22/2024] [Indexed: 05/06/2024]
Abstract
Key Points Mean baseline levels of perceived social support (Multidimensional Scale of Perceived Social Support) were comparable with other chronically ill populations. Higher Multidimensional Scale of Perceived Social Support scores were correlated with lower levels of fatigue, pain, depressive symptoms, anxiety, better sleep quality, and health-related quality of life (Short Form-12 Mental Component Score). Moderation analyses revealed male sex and non-Hispanic ethnicity resulted in stronger positive associations of perceived social support with Short Form-12 Mental Component Score. Background Patients with ESKD experience high symptom burden, which has been associated with a negative effect on their interpersonal relationships. However, there is limited research exploring associations of social support and patient-reported outcomes among patients receiving hemodialysis. Methods This study is a secondary, cross-sectional analyses of the sociodemographic and clinical correlates of perceived social support (Multidimensional Scale of Perceived Social Support [MSPSS]) at baseline. The study examined the extent to which perceived social support is associated with pain, depression, fatigue, anxiety, sleep, and health-related quality of life (Short Form-12 [SF-12] Mental Component Score [MCS] and Physical Component Score. Results Of the 160 randomized patients, the mean (SD) age was 58±14 years; years on dialysis was 4.1±4.2; 45% were female; 29% Black, 13% American Indian, and 18% Hispanic; 88% had at least high school education; and 27% were married. Mean baseline levels of perceived social support were comparable with other chronically ill populations. At least high school education (P = 0.04) and being married (P = 0.05) were associated with higher total MSPSS scores. Higher MSPSS scores were correlated with lower levels of fatigue (r =0.21, P = 0.008; higher fatigue scores signify lower fatigue), pain (r =−0.17, P = 0.03), depressive symptoms (r =−0.26, P < 0.001), anxiety (r =−0.23, P = 0.004), better sleep quality (r =−0.32, P < 0.001), and SF-12 MCS (r =0.26, P < 0.001). Moderation analyses revealed male sex and non-Hispanic ethnicity resulted in stronger positive associations of perceived social support with SF-12 MCS. Conclusions The level of perceived social support observed among patients receiving thrice-weekly hemodialysis in Technology Assisted Stepped Collaborative Care was similar to those observed in other chronic conditions. Because of the associations between perceived social support and patient-reported outcomes, particularly psychosocial and behavioral health outcomes, targeting social support appears to be warranted among patients receiving hemodialysis. Clinical Trial registration number: ClinicalTrials.gov NCT03440853 .
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Affiliation(s)
- Sarah J. Erickson
- Department of Psychology, University of New Mexico, Albuquerque, New Mexico
| | - Jonathan G. Yabes
- Division of General Internal Medicine, Department of Medicine and Biostatistics, Center for Research on Heath Care Data Center, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Zhuoheng Han
- Renal-Electrolyte Division, Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Maria-Eleni Roumelioti
- Division of Nephrology, Department of Internal Medicine, University of New Mexico School of Medicine Albuquerque, New Mexico
| | - Bruce L. Rollman
- Division of General Internal Medicine, Center for Behavioral Health, Media, and Technology, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Steven D. Weisbord
- Renal Section, Center for Health Equity Research and Promotion, VA Pittsburgh Healthcare System, Pittsburgh, Pennsylvania
| | - Jennifer L. Steel
- Department of Surgery, Psychiatry and Psychology, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Mark L. Unruh
- Division of Nephrology, Department of Internal Medicine, University of New Mexico School of Medicine Albuquerque, New Mexico
| | - Manisha Jhamb
- Renal-Electrolyte Division, Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
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Kisomi ZS, Taherkhani O, Mollaei M, Esmaeily H, Shirkhanloo G, Hosseinkhani Z, Amerzadeh M. The moderating role of social support in the relationship between death anxiety and resilience among dialysis patients. BMC Nephrol 2024; 25:100. [PMID: 38493124 PMCID: PMC10943903 DOI: 10.1186/s12882-024-03533-x] [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: 01/12/2024] [Accepted: 03/04/2024] [Indexed: 03/18/2024] Open
Abstract
BACKGROUND Chronic Kidney Disease (CKD) who receive social support can cope with the challenges. Therefore, this study determined the moderating role of social support in the relationship between death anxiety and resilience among dialysis patients in Qazvin City. METHODS This cross-sectional study used a descriptive-analytical approach on 347 dialysis patients in Qazvin City. The data collection tools included several questionnaires. The convenience sampling method was employed. The data were analyzed using SPSS software version 22 and mplus software version 7.2, employing descriptive statistics, such as mean and standard deviation for continuous variables and using counts and percentages for categorical/nominal variables. Regression analysis and tests were used to examine the relationships between variables. Structural Equation Modeling (SEM) analysis was employed to determine direct and indirect relationships between independent and dependent variables. RESULTS The prevalence of death anxiety was high (48.3%) among the patients. The mean resilience score was 62.59 ± 15.69, and the mean social support score was 52.23 ± 10.21. There was a significant association between resilience and social support (P < 0.001), as well as between resilience and death anxiety (P < 0.001). Furthermore, a significant relationship was observed between social support and death anxiety (p = 0.015). In the analysis of SEM, both the direct and indirect relationships between resilience and death anxiety were significant through the mediating variable of social support. CONCLUSION This study demonstrates that there is a relationship between death anxiety and resilience, and social support significantly moderates the relationship between death anxiety and resilience.
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Affiliation(s)
- Zahra Shafiei Kisomi
- Social Determinants of Health Research Center, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Omid Taherkhani
- Student Research Committee, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Mina Mollaei
- Student Research Committee, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Hoda Esmaeily
- Student Research Committee, Qazvin University of Medical Sciences, Qazvin, Iran
| | | | - Zahra Hosseinkhani
- Metabolic Diseases Research Center, Research Institute for Prevention of Non-Communicable Diseases, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Mohammad Amerzadeh
- Social Determinants of Health Research Center, Research Institute for Prevention of Non-Communicable Diseases, Qazvin University of Medical Sciences, Qazvin, Iran.
- Department of Healthcare Management, School of Public Health, Qazvin University of Medical Sciences (QUMS), Qazvin, Iran.
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Alshammari B, Alkubati SA, Pasay-an E, Alrasheeday A, Madkhali N, Edison JS, Bakthavatchaalam V, Alshammari MS, AlRashidi AA, Alshammari F. The influence of social support on sleep and fatigue level among patients receiving hemodialysis in Saudi Arabia: a cross-sectional correlational design. Front Psychol 2023; 14:1272500. [PMID: 38148785 PMCID: PMC10749965 DOI: 10.3389/fpsyg.2023.1272500] [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] [Received: 08/14/2023] [Accepted: 11/27/2023] [Indexed: 12/28/2023] Open
Abstract
Background Patients on hemodialysis (HD) are more likely to experience sleep problems and fatigue that may affect their health outcomes. Management of these patients with social support may improve their sleep quality and fatigue as well as their health. Aim This study aimed to assess the influence of social support on sleep quality and fatigue levels among HD patients. Methods A cross-correlational study was conducted among 260 conveniently sampled HD patients from four dialysis centers in Hail and Al-Qassim cities of Saudi Arabia from Jun 2022 to January 2023. Besides sociodemographic data, the Pittsburgh Sleep Quality Index (PSQI), the Multidimensional Assessment of Fatigue (MAF) and the Oslo Social Support Scale (OSSS-3) were used to assess sleep quality, fatigue levels and social support, respectively. Chi-square test was used to determine the association between categorical variables, while Pearson's correlation coefficient was used to test the correlation between sleep quality, fatigue, and social support. Results Poor sleep and high fatigue were significantly higher in older patients compared to younger patients (p <0.001), while strong social support was significantly lower in older patients than younger and middle-aged ones (p = 0.001). On the other hand, poor sleep and high fatigue were significantly higher in males than females (p = 0.022 and p <0.001, respectively), while strong social support was significantly higher in females than males (p <0.001). Married patients showed significantly poorer sleep than single ones (p = 0.019), but single patients received significantly stronger social support. Retired patients showed significantly poorer sleep, higher fatigue and weaker social support than other groups (p <0.001). There was a significant negative correlation between fatigue and sleep quality among HD patients, where patients with more fatigue had poorer sleep (r = -0.510, p <0.001). A significant positive correlation was found between social support and sleep quality, where patients with stronger social support had more normal sleep (r = 0.415, p <0.001). However, a significant negative correlation was found between social support and fatigue, where patients with stronger social support had lower levels of fatigue (r = -0.479, p <0.001). Conclusion Saudi patients on HD who have stronger social support have better sleep quality and reduced fatigue levels than those with less social support. There is a need to design and implement intervention studies with structured social support programs, and to evaluate their effectiveness on improving sleep and reducing fatigue among HD patients.
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Affiliation(s)
- Bushra Alshammari
- Department of Medical Surgical Nursing, College of Nursing, University of Hail, Hail, Saudi Arabia
| | - Sameer A. Alkubati
- Department of Medical Surgical Nursing, College of Nursing, University of Hail, Hail, Saudi Arabia
- Department of Nursing, Faculty of Medicine and Health Sciences, Hodeida University, Hodeida, Yemen
| | - Eddieson Pasay-an
- Department of Medical Surgical Nursing, College of Nursing, University of Hail, Hail, Saudi Arabia
| | - Awatif Alrasheeday
- Department of Nursing Administration, College of Nursing, University of Hail, Hail, Saudi Arabia
| | - Norah Madkhali
- Department of Nursing, College of Nursing, Jazan University, Jazan, Saudi Arabia
| | - J. Silvia Edison
- Department of Medical Surgical Nursing, College of Nursing, University of Hail, Hail, Saudi Arabia
| | | | - Marim Saud Alshammari
- Department of Health Awareness, King Salman Specialist Hospital, Hail Health Cluster, Hail, Saudi Arabia
| | - Amnah Ayed AlRashidi
- Department of Obstetrics and Gynecology, Hail General Hospital, Hail Health Cluster, Hail, Saudi Arabia
| | - Farhan Alshammari
- Department of Pharmaceutics, College of Pharmacy, University of Hail, Hail, Saudi Arabia
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Nassar MK, Tharwat S, Abdel-Gawad SM, Elrefaey R, Elsawi AA, Elsayed AM, Nagy E, Shabaka S, Shemies RS. Symptom burden, fatigue, sleep quality and perceived social support in hemodialysis patients with musculoskeletal discomfort: a single center experience from Egypt. BMC Musculoskelet Disord 2023; 24:788. [PMID: 37794377 PMCID: PMC10548648 DOI: 10.1186/s12891-023-06910-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Accepted: 09/24/2023] [Indexed: 10/06/2023] Open
Abstract
BACKGROUND AND AIMS Musculoskeletal disorders (MSDs) are commonly encountered in hemodialysis (HD) patients. However, the causes linked to these disorders are still partially defined. The aim of this study was to determine the frequency of MSDs and their relationship to a variety of clinico-social characteristics such as sleep quality, mood disorders, fatigue, and social support, in addition to the patients' clinical and therapeutic profile. METHOD The study included 94 patients on maintenance HD. Clinical and Sociodemographic data was gathered. To investigate the prevalence and trends of MSDs, the Nordic Musculoskeletal Questionnaire (NMQ-E) was employed. Patients completed the modified Edmonton Symptom Assessment System, Pittsburgh Sleep Quality Index (PSQI), multidimensional Fatigue Inventory (MFI-20), and Perceived Social Support from Family Scales. Univariate and multivariate regression analysis were used to assess the determinants of MSDs. RESULTS The patients' mean age was 49.73 and 59.6% were males. Seventy-two percent of patients were afflicted by MSDs. Knee pain (48.9%), low back pain (43.6%), shoulder pain (41.6%), hip/thigh pain (35.1%), and neck pains (35.1%) were the most reported MSD domains. Pain (p = 0.001), fatigue (p = 0.01), depression (p = 0.015), and anxiety (p = 0.003) scores were substantially higher in patients with MSDs. Furthermore, patients with MSDs engaged in less physical activity (p = 0.02) and perceived less social support (p = 0.029). Patients with MSDs had lower subjective sleep quality, daytime dysfunction domains, and global PSQI scores (p = 0.02, 0.031, 0.036, respectively). Female gender (p = 0.013), fatigue (p = 0.012), depression (p = 0.014), anxiety (p = 0.004), lower activity (p = 0.029), and PSQI score (0.027), use of erythropoiesis-stimulating agents (ESAs), antihypertensive drugs, calcium and Iron supplementation were all significantly associated with MSDs. At the multivariable regression model, administration of ESAs (p = 0.017) and pain score (p = 0.040) were the only independent variables associated with the outcome. CONCLUSION MSDs are quite common among HD patients. Female gender, pain, fatigue, depression, anxiety, reduced activity, poor sleep quality, and use of ESAs are all significantly associated with MSDs in HD patients. Patients with MSD perceived less social support compared to the other group. Patients treated with antihypertensive drugs, calcium and iron supplements were more likely to suffer MSDs.
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Affiliation(s)
- Mohammed Kamal Nassar
- Mansoura Nephrology & Dialysis Unit (MNDU), Faculty of Medicine, Mansoura University, El Gomhurria St, Mansoura, 35516, Egypt
| | - Samar Tharwat
- Rheumatology & Immunology Unit, Department of Internal Medicine, Faculty of Medicine, Mansoura University, Mansoura, Egypt
| | - Sara M Abdel-Gawad
- Mansoura Nephrology & Dialysis Unit (MNDU), Faculty of Medicine, Mansoura University, El Gomhurria St, Mansoura, 35516, Egypt
| | - Rabab Elrefaey
- Mansoura Nephrology & Dialysis Unit (MNDU), Faculty of Medicine, Mansoura University, El Gomhurria St, Mansoura, 35516, Egypt
| | - Alaa A Elsawi
- Mansoura Nephrology & Dialysis Unit (MNDU), Faculty of Medicine, Mansoura University, El Gomhurria St, Mansoura, 35516, Egypt
| | | | - Eman Nagy
- Mansoura Nephrology & Dialysis Unit (MNDU), Faculty of Medicine, Mansoura University, El Gomhurria St, Mansoura, 35516, Egypt
| | - Shimaa Shabaka
- Mansoura Nephrology & Dialysis Unit (MNDU), Faculty of Medicine, Mansoura University, El Gomhurria St, Mansoura, 35516, Egypt
| | - Rasha Samir Shemies
- Mansoura Nephrology & Dialysis Unit (MNDU), Faculty of Medicine, Mansoura University, El Gomhurria St, Mansoura, 35516, Egypt.
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Ramadan Y, Elkoofy N, Sabry S, Mansour G, El-Anwar N. Fatigue assessment and its predictors in pediatric patients with chronic kidney disease stages III to V. EGYPTIAN PEDIATRIC ASSOCIATION GAZETTE 2023. [DOI: 10.1186/s43054-022-00155-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
Abstract
Abstract
Background
Chronic fatigue is an intense subjective feeling of mental or physical exhaustion. It influences patients’ daily functioning and quality of life, delays recovery, and increases mortality, especially in chronic kidney disease (CKD) patients. The aim of this study is to assess and determine predictors of chronic fatigue in children with ESRD, dialysis, and pre-dialysis stages that can affect the patients’ quality of life (QOL).
Methods
We conducted a cross-sectional study on 114 patients diagnosed with CKD stages III to V, following at the nephrology outpatient clinic and hemodialysis (HD) unit of Cairo University Children’s Hospital during the period September 2020 till April 2021. Demographic and laboratory data of patients were gathered, and dialytic analysis in the form of frequency, duration of dialysis sessions, and adequacy of hemodialysis was calculated. The fatigue severity score (FSS) questionnaire was used to assess fatigue’s effects on daily functions, querying its relationship to motivation, physical activity, work, family, and social life.
Results
The mean age in the current study was (8.8 ± 1.8) years, with 62% being males. The median FSS score was 5.8, with a higher FSS score in stage V CKD patients. High e-GFR, serum sodium, folic acid, and L-carnitine supplementation all reduced the intensity of fatigue, while prolonged HD duration, acidosis, hypertension, and non-compliance to vitamin D replacement increased tiredness severity.
Conclusion
Routine fatigue assessment and measures to reduce it is a fundamental issue in pediatric CKD patients for better QOL.
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ALATAŞ H, ARSLAN N, PEMBEGÜL İ. The relationship of dietary antioxidant capacity with laboratory and anthropometric measurements in hemodialysis patients. JOURNAL OF HEALTH SCIENCES AND MEDICINE 2023. [DOI: 10.32322/jhsm.1218704] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
Aim: Dietary antioxidant intake correlates with blood antioxidant content and protects against oxidative damage and related inflammatory complications. This study was conducted to examine the relationship between total antioxidant capacity of diet and effective factors with laboratory and anthropometric parameters in patients undergoing hemodialysis. Material and Method: The present case-control study consisted of 62 cases and 59 controls individuals who received hemodialysis treatment between the ages of 35-75. Dietary intake, sociodemographic data, medical history, and anthropometric measurements were collected from participants using a validated questionnaire. Results: Examining the association between dietary components and diet's total antioxidant capacity (dTAC) reveals a positive correlation between dietary protein (kg/avg), beta carotene (mcg/day), vitamin C (mg/day), vitamin E (mg/day), and polyunsaturated fatty acids (PUFA) (g/day) (p=0.002). The serum albumin, serum neutrophil to lymphocyte ratio and HDL-cholesterol have been reported to have a positive relationship with dTAC. And body mass ındex (BMI) and other anthropometric parameters were found to have a negative connection with dTAC (p=0.007). Conclusion: Total dietary antioxidant capacity is effective on anthropometric measurements and serum laboratory values. Increasing the antioxidant capacity of the diet in hemodialysis patients is important to prevent complications related to inflammation.
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Huang Y, Chen M, Zhang Y, Chen X, Zhang L, Dong C. Finding family resilience in adversity: A grounded theory of families with children diagnosed with leukaemia. J Clin Nurs 2023. [PMID: 36597215 DOI: 10.1111/jocn.16615] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Revised: 11/25/2022] [Accepted: 12/15/2022] [Indexed: 01/05/2023]
Abstract
AIMS AND OBJECTIVES To develop a conceptual framework that explores the process of building family resilience among Chinese families with children diagnosed with leukaemia. BACKGROUND The diagnosis of childhood leukaemia has a devastating effect on the family. Nonetheless, some families were able to positively respond to the crisis. The process through which Chinese families bounce back has received little attention. DESIGN Grounded theory. METHODS This study used purposive and theoretical sampling to select 16 parents who agreed to participate in semistructured interviews after children were diagnosed with leukaemia. Data collection and analysis occurred simultaneously. Data were analysed through a process of open, axial and selective coding. The COREQ checklist was followed for reporting. RESULTS A core category of 'finding family resilience in adversity' was generated. The core category was underpinned by a transition process between two fluid stages: (a) Disrupting the family system, informed by subcategories of negative emotional disturbances and challenges of the diagnosis and treatment journey; (b) Cultivating resilience in families, informed by subcategories of increasing positive attitudes; establishing new family routines; activating good support systems; and practising open family communication. CONCLUSIONS The transition process from the disruption of the family system to the cultivation of family resilience is perceived as a complex family dynamic in response to childhood leukaemia. Our findings can form the basis for further research about resilience-based family interventions that promote family well-being during the early stages of a childhood leukaemia diagnosis. RELEVANCE TO CLINICAL PRACTICE It is necessary for healthcare professionals to provide essential support for families to face the challenges of diagnosis and treatment to facilitate the successful transition to family resilience. By understanding the dynamic process of developing family resilience, healthcare professionals are able to focus on these families to provide holistic care that satisfies the specific demands of family members.
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Affiliation(s)
- Yingying Huang
- The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China
| | - Meijia Chen
- School of Nursing, Wenzhou Medical University, Wenzhou, China
| | - Yao Zhang
- School of Nursing, Wenzhou Medical University, Wenzhou, China
| | - Xuewei Chen
- School of Nursing, Wenzhou Medical University, Wenzhou, China
| | - Liping Zhang
- The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China
| | - Chaoqun Dong
- School of Nursing, Wenzhou Medical University, Wenzhou, 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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Wang S, Wang X, Liu X, Zhao C, Duan J. Moderating effects of humanistic care and socioeconomic status on the relationship among pain intensity, psychological factors, and psychological function in adults with cancer pain from a province of China: A cross-sectional study. Front Psychiatry 2023; 14:928727. [PMID: 37082761 PMCID: PMC10110900 DOI: 10.3389/fpsyt.2023.928727] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Accepted: 03/07/2023] [Indexed: 04/22/2023] Open
Abstract
Objective The objective of this study is to explore whether humanistic care practiced by clinical pharmacists and socioeconomic status moderate the associations among pain intensity, psychological factors (catastrophizing and resilience), and psychological function (depression and anxiety) in cancer patients with low levels of education and income in the Shanxi province in the Northwest of China. Methods Our sample comprised 123 adult inpatients with cancer pain. Demographic variables were obtained from the Hospital Information System of The Second Hospital of Shanxi Medical University. Pain intensity, psychological factors, and psychological functions were evaluated with four scales, and humanistic care was practiced with a part of the patients by clinical pharmacists. First, univariate analyses were conducted, followed by moderating effect models. Results The incidence of depression and anxiety in patients with cancer pain in our sample were 48.78 and 41.46%, respectively. Low levels of psychological resilience (63.37, SD 21.74) were in this study. Pain intensity was significantly associated with humanistic care and anxiety. Humanistic care practiced by clinical pharmacists moderated not only the association between resilience and pain intensity but also the association between pain intensity and anxiety. Education levels moderated the relationship between pain intensity and the psychological factors of catastrophizing and resilience. Income levels moderated the association between resilience and anxiety. Conclusion Humanistic care is essential in moderating the association among pain intensity, psychological factors, and psychological functions in Chinese cancer patients, especially those from lower-level counties and rural areas. Furthermore, socioeconomic statuses, such as education level and income, cannot easily change quickly. Still, proper humanistic care can relieve pain more effectively, reminding us that medical staff should implement effective personalized interventions to reduce patients' pain intensity.
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Affiliation(s)
- Shuyun Wang
- Department of Pharmacy, Second Hospital of Shanxi Medical University, Taiyuan, Shanxi, China
| | - Xuyan Wang
- School of Traditional Chinese Medicine and Food Engineering, Shanxi University of Traditional Chinese Medicine, Taiyuan, Shanxi, China
| | - Xiaohong Liu
- Department of Pharmacy, Yangquan First People's Hospital, Yangquan, Shanxi, China
| | - Chenxing Zhao
- Department of Pharmacy, Linfen People's Hospital, Linfen, Shanxi, China
| | - Jinju Duan
- Department of Pharmacy, Second Hospital of Shanxi Medical University, Taiyuan, Shanxi, China
- *Correspondence: Jinju Duan,
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Zhang D, Wei J, Li X. The mediating effect of social functioning on the relationship between social support and fatigue in middle-aged and young recipients with liver transplant in China. Front Psychol 2022; 13:895259. [PMID: 35992430 PMCID: PMC9382128 DOI: 10.3389/fpsyg.2022.895259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2022] [Accepted: 07/04/2022] [Indexed: 11/13/2022] Open
Abstract
ObjectiveThe objective of the study was to explore the relationship between social support and fatigue as well as the mediating role of social functioning on that relationship.BackgroundPsychosocial factors such as social support and social functioning may influence patients’ fatigue symptoms. There is limited evidence on the relationship between social support, social functioning, and fatigue in liver transplant recipients.MethodsA total of 210 patients with liver transplants from two tertiary hospitals were enrolled in the current study. Questionnaires used include one for general demographic data, the Perceived Social Support Scale (PSSS), Social Disability Screening Schedule (SDSS), and Fatigue Symptom Inventory (FSI).ResultsA total of 126 (60%) recipients reported fatigue. Gender, residence, BMI, and liver function were the primary factors affecting fatigue. Social support was positively correlated with social functioning and was negatively correlated with fatigue. The effect of social support on fatigue was partially mediated by social functioning (35.74%).ConclusionThe fatigue of liver transplant recipients should be attended to. The higher the social support, the lower the fatigue of liver transplant recipients. Social support may also reduce fatigue through social functioning. The liver transplant team should help the liver transplant recipient establish a social support system, restore social functioning, and reduce fatigue symptoms.
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Affiliation(s)
- Dan Zhang
- Nursing Department, The First Hospital of China Medical University, Shenyang, China
| | - Junling Wei
- Rehabilitation Department, Qingdao Hospital of Traditional Chinese Medicine, Qingdao, China
| | - Xiaofei Li
- Transplantation and Hepatobiliary Department, The First Hospital of China Medical University, Shenyang, China
- *Correspondence: Xiaofei Li,
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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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12
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Qiu Y, Huang Y, Wang Y, Ren L, Jiang H, Zhang L, Dong C. The Role of Socioeconomic Status, Family Resilience, and Social Support in Predicting Psychological Resilience Among Chinese Maintenance Hemodialysis Patients. Front Psychiatry 2021; 12:723344. [PMID: 34658959 PMCID: PMC8514615 DOI: 10.3389/fpsyt.2021.723344] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Accepted: 08/30/2021] [Indexed: 01/31/2023] Open
Abstract
Objectives: Evidence regarding the possible influence of social factors on psychological resilience among maintenance hemodialysis patients is scarce. The aim of this study was to explore the relationship among socioeconomic status, family resilience, and social support, and psychological resilience among Chinese maintenance hemodialysis patients. Methods: This cross-sectional study was conducted in the hemodialysis centers of three comprehensive hospitals in China from September to December 2020 using convenience sampling. Two hundred fifty-eight patients receiving maintenance hemodialysis were investigated using a sociodemographic questionnaire, the Chinese version of the Medical Outcomes Study-Social Support Survey (MOS-SSS), Chinese Family Resilience Assessment Scale (C-FRAS), and Chinese version of the Conner and Davidson resilience scale (CD-RISC). Results: Maintenance hemodialysis patients reported a low level of physical resilience, with a score of (58.92 ± 15.27). Hierarchical linear regression analysis showed that education level (β = 0.127, p = 0.018), maintenance of a positive outlook by the family (β = 0.269, p = 0.001), positive social interaction support from the family (β = 0.233, p = 0.002), and tangible support (β = -0.135, p = 0.037) were significantly associated with psychological resilience. Conclusion: SES, family resilience and social support may be potential predictive factors of psychological resilience. Interventions to improve the family resilience and social support may be beneficial to promote the psychological resilience of Chinese maintenance hemodialysis patients.
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Affiliation(s)
- Yuan Qiu
- School of Nursing, Wenzhou Medical University, Wenzhou, China
| | - Yingying Huang
- The Second Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Yuxin Wang
- School of Nursing, Wenzhou Medical University, Wenzhou, China
| | - Liya Ren
- School of Nursing, Wenzhou Medical University, Wenzhou, China
| | - Hao Jiang
- School of Nursing, Wenzhou Medical University, Wenzhou, China
| | - Liping Zhang
- The Second Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Chaoqun Dong
- School of Nursing, Wenzhou Medical University, Wenzhou, China
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13
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Ju A, Teixeira-Pinto A, Tong A, Smith AC, Unruh M, Davison SN, Dapueto J, Dew MA, Fluck R, Germain MJ, Jassal SV, Obrador GT, O'Donoghue D, Viecelli AK, Strippoli G, Ruospo M, Timofte D, Sharma A, Au E, Howell M, Costa DSJ, Anumudu S, Craig JC, Rutherford C. Validation of a Core Patient-Reported Outcome Measure for Fatigue in Patients Receiving Hemodialysis: The SONG-HD Fatigue Instrument. Clin J Am Soc Nephrol 2020; 15:1614-1621. [PMID: 33093215 PMCID: PMC7646231 DOI: 10.2215/cjn.05880420] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Accepted: 09/03/2020] [Indexed: 12/13/2022]
Abstract
BACKGROUND AND OBJECTIVES Fatigue is a very common and debilitating symptom and identified by patients as a critically important core outcome to be included in all trials involving patients receiving hemodialysis. A valid, standardized measure for fatigue is needed to yield meaningful and relevant evidence about this outcome. This study validated a core patient-reported outcome measure for fatigue in hemodialysis. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS A longitudinal cohort study was conducted to assess the validity and reliability of a new fatigue measure (Standardized Outcomes in Nephrology-Hemodialysis Fatigue [SONG-HD Fatigue]). Eligible and consenting patients completed the measure at three time points: baseline, a week later, and 12 days following the second time point. Cronbach α and intraclass correlation coefficient were calculated to assess internal consistency, and Spearman rho was used to assess convergent validity. Confirmatory factor analysis was also conducted. Hemodialysis units in the United Kingdom, Australia, and Romania participated in this study. Adult patients aged 18 years and over who were English speaking and receiving maintenance hemodialysis were eligible to participate. Standardized Outcomes in Nephrology-Hemodialysis, the Visual Analog Scale for fatigue, the 12-Item Short Form Survey, and Functional Assessment of Chronic Illness Therapy-Fatigue were used. RESULTS In total, 485 participants completed the study across the United Kingdom, Australia, and Romania. Psychometric assessment demonstrated that Standardized Outcomes in Nephrology-Hemodialysis is internally consistent (Cronbach α =0.81-0.86) and stable over a 1-week period (intraclass correlation coefficient =0.68-0.74). The measure demonstrated convergence with Functional Assessment of Chronic Illness Therapy-Fatigue and had moderate correlations with other measures that assessed related but not the same concept (the 12-Item Short Form Survey and the Visual Analog Scale). Confirmatory factor analysis supported the one-factor model. CONCLUSIONS SONG-HD Fatigue seems to be a reliable and valid measure to be used in trials involving patients receiving hemodialysis.
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Affiliation(s)
- Angela Ju
- Faculty of Medicine and Health, Sydney School of Public Health, University of Sydney, Sydney, New South Wales, Australia .,Centre for Kidney Research, The Children's Hospital at Westmead, Sydney, New South Wales, Australia.,Faculty of Science, Quality of Life Office, School of Psychology, University of Sydney, Sydney, Australia
| | - Armando Teixeira-Pinto
- Faculty of Medicine and Health, Sydney School of Public Health, University of Sydney, Sydney, New South Wales, Australia.,Centre for Kidney Research, The Children's Hospital at Westmead, Sydney, New South Wales, Australia
| | - Allison Tong
- Faculty of Medicine and Health, Sydney School of Public Health, University of Sydney, Sydney, New South Wales, Australia.,Centre for Kidney Research, The Children's Hospital at Westmead, Sydney, New South Wales, Australia
| | - Alice C Smith
- Department of Health Sciences, University of Leicester, Leicester, United Kingdom
| | - Mark Unruh
- Division of Nephrology, University of New Mexico School of Medicine, Albuquerque, New Mexico
| | - Sara N Davison
- Division of Nephrology and Immunology, Department of Medicine, University of Alberta, Edmonton, Alberta, Canada
| | - Juan Dapueto
- Departamento de Psicología Médica, Hospital de Clínicas, Facultad de Medicina, Universidad de la República, Montevideo, Uruguay
| | - Mary Amanda Dew
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Richard Fluck
- Department of Renal Medicine, Royal Derby Hospital, Derby, United Kingdom
| | - Michael J Germain
- Division of Nephrology, Renal and Transplant Associates of New England, Baystate Medical Center, University of Massachusetts School of Medicine, Springfield, Massachusetts
| | - Sarbjit V Jassal
- Division of Nephrology, Department of Medicine, University Health Network, University of Toronto, Toronto, Ontario, Canada
| | - Gregorio T Obrador
- Department of Epidemiology, Biostatistics, and Public Health, Universidad Panamericana School of Medicine, Mexico City, Mexico
| | - Donal O'Donoghue
- Department of Renal Medicine, Salford Royal Hospital, Salford, United Kingdom
| | - Andrea K Viecelli
- Department of Nephrology, Princess Alexandra Hospital, Brisbane, Queensland, Australia.,Australasian Kidney Trials Network, Centre for Health Services Research, University of Queensland, Brisbane, Queensland, Australia
| | - Giovanni Strippoli
- Faculty of Medicine and Health, Sydney School of Public Health, University of Sydney, Sydney, New South Wales, Australia.,Centre for Kidney Research, The Children's Hospital at Westmead, Sydney, New South Wales, Australia.,Department of Emergency and Organ Transplantation, University of Bari, Bari, Italy
| | - Marinella Ruospo
- Department of Emergency and Organ Transplantation, University of Bari, Bari, Italy
| | - Delia Timofte
- Department of Dialysis, Emergency University Hospital, Bucharest, Romania
| | - Ankit Sharma
- Faculty of Medicine and Health, Sydney School of Public Health, University of Sydney, Sydney, New South Wales, Australia.,Centre for Kidney Research, The Children's Hospital at Westmead, Sydney, New South Wales, Australia
| | - Eric Au
- Faculty of Medicine and Health, Sydney School of Public Health, University of Sydney, Sydney, New South Wales, Australia .,Centre for Kidney Research, The Children's Hospital at Westmead, Sydney, New South Wales, Australia
| | - Martin Howell
- Faculty of Medicine and Health, Sydney School of Public Health, University of Sydney, Sydney, New South Wales, Australia.,Centre for Kidney Research, The Children's Hospital at Westmead, Sydney, New South Wales, Australia
| | - Daniel S J Costa
- Faculty of Medicine and Health, Pain Management Research Institute, Royal North Shore Hospital, New South Wales, Sydney, Australia
| | - Samaya Anumudu
- Section of Nephrology, Selzman Institute for Kidney Health, Baylor College of Medicine, Houston, Texas
| | - Jonathan C Craig
- College of Medicine and Public Health, Flinders University, Adelaide, Australia
| | - Claudia Rutherford
- Faculty of Science, Quality of Life Office, School of Psychology, University of Sydney, Sydney, Australia.,The University of Sydney, Susan Wakil School of Nursing and Midwifery, Cancer Nursing Research Unit, Faculty of Medicine and Health, Sydney, Australia
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14
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Pasyar N, Rambod M, Jowkar M. The Effect of Peer Support on Hope Among Patients Under Hemodialysis. Int J Nephrol Renovasc Dis 2020; 13:37-44. [PMID: 32214839 PMCID: PMC7078768 DOI: 10.2147/ijnrd.s240756] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2019] [Accepted: 02/25/2020] [Indexed: 12/18/2022] Open
Abstract
Introduction Providing social support for patients under hemodialysis treatment can reduce their psychological, social, and physical problems. The present study aimed at determining the effect of peer support on hopefulness in patients under hemodialysis. Methods This clinical trial with a pre/posttest design was conducted on 128 patients who had referred to the hemodialysis centers of Shiraz University of Medical Sciences in 2019. The patients were randomly divided into an intervention and a control group. The patients in the intervention group were supported by their peers for eight weeks and were provided with the usual care, but the controls were only provided with the usual care. The data were collected using Snyder Hope Scale. Then, the data were entered into the SPSS software, version 18 and were analyzed using independent t-test and paired t-test. Results At baseline, the participants in both groups were similar with respect to the mean scores of hope and its subscales (p>0.05). However, there was a significant difference between the two groups in terms of hope and its subscales eight weeks after the intervention (p<0.001). Conclusion The results confirmed the effect of peer support on increasing hope among the patients under hemodialysis. Peer support in informational, emotional, instrumental, and spiritual forms could create a positive incentive and increase hope among the patients. Clinical Trial Number This clinical trial has been registered in the Iranian Registry of Clinical Trials (IRCT20190126042498N1).
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Affiliation(s)
- Nilofar Pasyar
- Community Based Psychiatric Care Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.,Nursing Department, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Masoume Rambod
- Community Based Psychiatric Care Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.,Nursing Department, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mostafa Jowkar
- Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
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15
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Karadag E, Samancioglu Baglama S. The Effect of Aromatherapy on Fatigue and Anxiety in Patients Undergoing Hemodialysis Treatment. Holist Nurs Pract 2019; 33:222-229. [DOI: 10.1097/hnp.0000000000000334] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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16
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Predicting Resilience via Social Support and Illness Perceptions Among Patients Undergoing Hemodialysis. ACTA ACUST UNITED AC 2017. [DOI: 10.5812/jjcdc.14427] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
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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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18
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Wang SY, Zang XY, Fu SH, Bai J, Liu JD, Tian L, Feng YY, Zhao Y. Factors related to fatigue in Chinese patients with end-stage renal disease receiving maintenance hemodialysis: a multi-center cross-sectional study. Ren Fail 2016; 38:442-50. [DOI: 10.3109/0886022x.2016.1138819] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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19
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Beggs RT, Holtzman S, DeLongis A. Predicting Daily Satisfaction with Spouse Responses Among People with Rheumatoid Arthritis. Ann Behav Med 2015; 50:24-33. [DOI: 10.1007/s12160-015-9728-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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20
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Aylaz R, Karadağ E, Işik K, Yildirim M. Relationship between social support and fatigue in patients with type 2 diabetes mellitus in the east of turkey. Jpn J Nurs Sci 2015; 12:367-76. [DOI: 10.1111/jjns.12076] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2014] [Accepted: 01/28/2015] [Indexed: 12/01/2022]
Affiliation(s)
- Rukuye Aylaz
- Department of Public Health Nursing, School of Health; Inonu University; Malatya Turkey
| | - Ezgi Karadağ
- Department of Internal Medicine Nursing; Tunceli University Health High School; Tunceli Turkey
| | - Kevser Işik
- Department of Public Health Nursing, School of Health; Inonu University; Malatya Turkey
| | - Melek Yildirim
- Department of Internal Medicine Nursing; Malatya State Hospital; Malatya Turkey
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