Investigation of Effect on Activities of Daily Living and Symptoms in Hemodilaysis Patients

Background

Hemodialysis patients develop many physical and psychosocial symptoms associated with chronic kidney disease and its treatment. The presence of these symptoms also adversely affects an individual's activities of daily living.

Aim

The aim of this study was to evaluate the symptoms seen in hemodilaysis patients and to examine the effect on daily living activities.

Materials and Methods

This was a cross-sectional descriptive study carried out on 126 patients in two dialysis centers in Turkey. Patient Information Form, Dialysis Symptom Index (DSI) and Katz Activities of Daily Living Scale (KADL) were used as data collection tools.

Results

The most frequent symptoms described by the patients undergoing hemodialysis were tiredness, sadness, and muscle-joint pain. The mean of the DSI was 30.03 (SD: 14.7). There was a statistically significant relationship between dialysis symptom index and disease duration and hemodialysis vintage (P < 0.05). In addition, the mean score of the Patients' KADL was 14.48 (SD: 2.55). Eighty-two (65.1%) patients maintain their daily living activities independently. On the other hand, 26.2% of the dialysis patients maintained their daily living activities as semi-dependent, while 8.7% were totally dependent on others. A statistically significant relationship was found between KADL, marital status, year of dialysis and presence of another chronic disease (P < 0.05). There was statistically significant relationship between DSI and KADL. In hemodilaysis patients, as the DSI score increased, the dependence on daily living activities increased.

Conclusion

The symptoms seen in patients have a negative effect on maintaining their daily living activities. Health workers should perform symptom evaluation in patients undergoing dialysis. Thus, each patient-specific individualized care plan should be designed for effective management of these symptoms in patients. Effective symptom management will be effective in maintaining patients' daily living activities.

Does intrauterine tobacco exposure increase the pain perception of newborns?

Background

This study aimed to assess whether there was a difference in the pain-perception levels of newborns born to mothers who smoked during pregnancy and newborns born to mothers who were not exposed to active or passive smoking during pregnancy.

Materials and methods

A total of 60 newborns born by normal spontaneous vaginal birth between June 2013 and June 2014 were included in the study: 30 born to mothers who smoked during pregnancy, and 30 born to mothers not exposed to smoking. Mothers or newborns who had taken analgesics or sedative medications in the previous 24 hours, newborns not born at term, and sick newborns were not included in the study. During the routine hepatitis B-vaccination injection given at postnatal 48 hours, the newborns’ behavior was monitored and recorded by video camera. The data obtained from the recordings were evaluated according to the Neonatal Pain, Agitation, and Sedation Scale and analyzed with SPSS 20.

Results

The median pain score of the group exposed to tobacco smoke in utero was 8.5, while the median pain score of the unexposed group was 6 (P<0.001).

Conclusion

Exposure to tobacco smoke in utero may increase the pain-perception levels of newborns.