Postdialysis Fatigue and Comfort Levels of Patients Receiving Hemodialysis Treatment
Year 2024,
Volume: 6 Issue: 2, 356 - 365
Özlem Özdemir
Abstract
Aim: In this study aimed to determine postdialysis fatigue and comfort levels in patients receiving hemodialysis treatment and the factors affecting them.
Material and Method: The study is a descriptive and cross-sectional research. It was completed with 112 patients receiving regular hemodialysis treatment. Patient Evaluation Form, Postdialysis Fatigue Scale and Hemodialysis Comfort Scale were used to collect data.
Results: The mean score of the Postdialysis Fatigue Scale was 35.73 ± 11.80. The mean score of the Hemodialysis Comfort Scale was 24.57 ± 8.91. There was a negative correlation between the Postdialysis Fatigue Scale score and the Hemodialysis Comfort Scale score of the patients (r=-0.558, p=0.000). The results of the multiple regression analysis were significant predictors of the presence of complaints between two dialysis, postdialysis blood pressure levels and postdialysis fatigue level of comfort levels (p<0.05).
Conclusion: Postdialysis fatigue and comfort level were above average. Postdialysis fatigue negatively affects the comfort of patients. While the presence of symptoms in patients between two dialysis sessions decreased comfort, the decrease in blood pressure after dialysis increased the comfort level. Postdialysis fatigue and comfort should be routinely evaluated in patients receiving hemodialysis treatment by nurses. Postdialysis fatigue should not be underestimated.
Ethical Statement
Ethics committee approval was received for this study from the Kirklareli Institute of Health Sciences Research Ethics Committee (Date: 20.06.2022, and No: P4506R0)
Supporting Institution
There was not financial support
Thanks
We would like to thank all healthcare professionals working in the dialysis center where the study was conducted, and patients participating in the study.
References
- Bilgiç. Ş., Pamuk Cebeci. S. (2022). Relationship between stressors and comfort level in hemodialysis patients. Archives of Health Science and Research, 9(2),105–109. doi:10.54614/ArcHealthSciRes.2022.21146
- Borzou. S. R., Anosheh. M., Mohammad. E., Kazemnejad. A. (2014). Patients’ perception of comfort facilitators during hemodialysis procedure: A qualitative study. Iranian Red Crescent Medical Journal, 16(7), e19055. doi.org:10.5812/ircmj.19055
- Bossola. M., Di Stasio. E., Giungi. S., Rosa. F., Tazza. L. (2015). Fatigue is associated with serum interleukin-6 levels and symptoms of depression in patients on chronic hemodialysis. Journal of Pain and Symptom Management, 49(3), 578–85. https://doi.org/10.1016/j.jpainsymman.2014.07.009
- Bossola. M., Marzetti. E., Di Stasio. E., Monteburini. T., Cenerelli. S., Mazzoli., …Vulpio. C. (2018). Prevalence and associated variables of post-dialysis fatigue: Results of a prospective multicentre study. Nephrology, 23(6), 552–58. https://doi.org/10.1111/nep.13059
- Bossola. M., Picca. A., Monteburini. T., Parodi. E., Santarelli. S., … Di Stasio. E. (2021). Postdialysis fatigue and survival in patients on chronic hemodialysis. Journal of Nephrology, 34(6), 2163–65.doi: 10.1007/s40620-021-01141-8.
- Bossola. M., Tazza. L. (2016). Postdialysis Fatigue: A frequent and debilitating symptom. Seminars in Dialysis, 29(3), 222–27. doi:10.1111/sdi.12468
- Bossola. M., Vulpio. C., Tazza. L. (2011). Fatigue in chronic dialysis patients. Seminars in Dialysis, 24(5), 550-55. doi:10.1111/j.1525-139X.2011.00956
- Boudiab. L. D., Kolcaba. K. (2015). Comfort theory: Unraveling the complexities of veterans’ health care needs. Advances in Nursing Science, 38(4), 270–78. doi:10.1097/ANS.0000000000000089
- Daugirdas J. T. (1993). Second generation logarithmic estimates of single-pool variable volume Kt/V: an analysis of error. Journal of the American Society of Nephrology, 4(5), 1205-13. doi:10.1681/ASN.V451205
- Debnath. S., Rueda. R., Bansal. S., Kasinath. B. S., Sharma. K., Lorenzo. C. (2021). Fatigue characteristics on dialysis and non-dialysis days in patients with chronic kidney failure on maintenance hemodialysis. BMC Nephrology, 22(1), 112. doi:10.1186/s12882-021-02314-0
- Dikmen. R. D., Aslan. H. (2020). Clinical Nephrology and renal care the effects of the symptoms experienced by patients receiving hemodialysis treatment on their comfort levels. Journal Of Clinical Nephrology and Renal Care, 6(60), 2–9.doi: 10.23937/2572-3286/1510060.
- Dubin. R. F., Teerlink. J. R., Schiller. N. B., Alokozai. D., Peralta. C. A., Johansen. K. L. (2013). Association of segmental wall motion abnormalities occurring during hemodialysis with post-dialysis fatigue. Nephrology Dialysis Transplantation, 28(10), 2580–85. doi:10.1093/ndt/gft097
- Elsayed. M. M., Zeid. M. M., Hamza O. M. R., Elkholy. N. M. (2022). Dialysis recovery time: associated factors and its association with quality of life of hemodialysis patients. BMC Nephrology, 23(1), 298. doi:10.1186/s12882-022-02926-0
- Estridge. K., Morris. D., Kolcaba. K., Winkelman. C. (2018). Comfort and fluid retention in adult patients receiving hemodialysis. Nephrology Nursing Journal, 45(1), 25–33.
- Gülay. T., Özdemir Eller. Ç., Ökdem. Ş., Akgün Çıtak. E. (2020). Hemodiyaliz hastalarında konfor düzeyinin incelenmesi. Hacettepe Üniversitesi Hemşirelik Fakültesi Dergisi, 7(2), 122–29. doi.:10.31125/hunhemsire.763155
- Joshwa. B.,Peters. R. M.,Malek. M. H., Yarandi. H. N., Campbell. M. L. (2020). Multiple Dimensions and Correlates of Fatigue in Individuals on Hemodialysis. Nephrology Nursing Journal : Journal of the American Nephrology Nurses’ Association, 47(3), 215–51. doi: 10.37526/1526-744x.2020.47.3.215.
- Kacaroǧlu Vicdan. A. (2020). The Effect of Training Given to hemodialysis patients according to the comfort theory. Clinical Nurse Specialist, 34(1), 30–7. doi: 10.1097/NUR.0000000000000495.
- Kang. H.,Chae. Y. (2021). Effects of integrated indirect forest experience on emotion, fatigue, stress and immune function in hemodialysis patients. International Journal of Environmental Research and Public Health, 18(4), 1–12. doi: 10.3390/ijerph18041701
- Kodama. H., Togari. T., Konno. Y., Tsuji. A., Fujinoki. A., Kuwabara. S., Inoue , T. (2020). A new assessment scale for postdialysis fatigue in hemodialysis patients. Renal Replacement Therapy, 6(1), 3-6. doi: 10.1186/s41100-019-0252-5.
- Kolcaba. K. (1994). A theory of holistic comfort for nursing. Journal of Advanced Nursing, 19(6), 1178–84.
- Li. H., Yin. J., Dong. Y., Tian., Z. (2023). Factors predicting postdialysis fatigue of maintenance hemodialysis
patients. Renal Replacement Therapy, 9(30),1-8. doi: 10.1186/s41100-023-00486-z
- McIntyre, C. W., Burton, J. O., Selby, N. M., Leccisotti, L., Korsheed, S., Baker, C. S., Camici, P. G. (2008). Hemodialysis-induced cardiac dysfunction is associated with an acute reduction in global and segmental myocardial blood flow. Clinical journal of the American Society of Nephrology, 3(1), 19–26. doi: 10.2215/CJN.03170707
- Melo. G. A. A., Aguiar. L. L., Silva. R. A., Quirino. G. da S., Pinheiro. A. K. B., Caetano. J. Á. (2019). Factors related to impaired comfort in chronic kidney disease patients on hemodialysis. Revista Brasileira de Enfermagem, 72(4), 889–95. doi: 10.1590/0034-7167-2018-0120
- Ozen. N., Aydin Sayilan. A., Bal Ozkaptan. B., Neves Sousa. C., Unver. V. (2021). The reliability and validity of the Turkish version of the postdialysis fatigue scale. International Journal of Clinical Practice, 75(11), e14871. doi:10.1111/ijcp.14871
- Özer. Z., Alkın Demir. C. (2022). Hemodiyaliz tedavisi alan hastalarda semptom ve konfor ilişkisi. Nefroloji Hemşireliği Dergisi, 1(17), 10–20. doi: 10.47565/ndthdt.2022.49.
- Provenzano. M.,Coppolino. G., Faga. T., Garofalo. C., Serra. R., Andreucci. M. (2019). Epidemiology of cardiovascular risk in chronic kidney disease patients: The real silent killer. Reviews in Cardiovascular Medicine, 20(4), 209–20. doi:10.31083/J.RCM.2019.04.548
- Registry of The Nephrology, Dialysis, and Transplatation (2021). Registry of the nephrology, dialysis and transplantation in Türkiye Registry 2022. Erişim tarihi 25. Nisan 2023,https://nefroloji.org.tr/uploads/files/REGISTRY_2022.PDF
- Şahi̇n. Orak. N., Çinar Pakyüz. S., Kartal. A. (2017). Ölçek Geliştirme çalışması: hemodiyaliz hastalarında konfor. Nefroloji Hemşireliği Dergisi, 2(12), 68–77.
- Santos. R.C.D., Melo G.A.A, Silva. R.A., Silva. F.L.B.D., Viana Júnior. A.B., Caetano. J.Á. (2020). Relationship between the comfort level of chronic renal patients and sociodemographic and clinical variables. Revista Brasileira de Enfermagem, 73(5), e20200085. doi: 10.1590/0034-7167-2020-0085.
- Smokovska. N., Grozdanovski. R., Spasovski. G. (2015). Impact of different variables on recovery time in patients receiving hemodialysis. BANTAO Journal, 13(1), 20–24. https://doi.org/10.1515/bj-2015-0005
- Tabiee. S., Momeni. A. Saadatjoo. S. A. (2017). The effects of comfort-based ınterventions (Back massage and patient and family education) on the level of comfort among hemodialysis patients. Modern Care Journal, 14(3). e64687. doi:10.5812/modernc.64687
- You, Q., Bai. D. X., Wu. C. X., Chen. H., Hou. C. M., Gao. J. (2022). Prevalence and Risk Factors of Postdialysis Fatigue in Patients Under Maintenance Hemodialysis: A Systematic Review and Meta-Analysis. Asian Nursing Research, 16(5), 292–98. doi: 10.1016/j.anr.2022.11.002.
- Zadrazil. J., Horak. P. (2015). Pathophysiology of anemia in chronic kidney diseases: A review. Biomedical Papers, 159(2), 197–202. doi.:10.5507/bp.2013.093
Hemodiyaliz Tedavisi Gören Hastaların Diyaliz Sonrası Yorgunluk ve Konfor Düzeyleri
Year 2024,
Volume: 6 Issue: 2, 356 - 365
Özlem Özdemir
Abstract
Amaç: Bu çalışmada, hemodiyaliz tedavisi gören hastaların diyaliz sonrası yorgunluk ve konfor düzeyleri ve bunları etkileyen faktörleri belirlemek amaçlandı.
Gereç ve Yöntem: Çalışma tanımlayıcı ve kesitsel bir araştırmadır. Çalışma, düzenli hemodiyaliz tedavisi gören 112 hasta ile tamamlandı. Verilerin toplanmasında Hasta Değerlendirme Formu, Diyaliz Sonrası Yorgunluk Ölçeği ve Hemodiyaliz Konfor Ölçeği kullanıldı.
Bulgular: Diyaliz Sonrası Yorgunluk Ölçeği'nin ortalama puanı 35.73 ± 11.80 idi. Hemodiyaliz Konfor Ölçeği ortalama puanı 24.57 ± 8.91 idi. Hastaların diyaliz sonrası yorgunluk ölçeği puanı ile Hemodiyaliz Konfor Ölçeği puanı arasında negatif bir ilişki vardı (r=-0.558, p=0.000). Çoklu regresyon analizi sonuçları, iki diyaliz arasında şikayet varlığı, diyaliz sonrası kan basıncı düzeyi ve diyaliz sonrası yorgunluk düzeyi konforun anlamlı yordayıcısıydı (p< 0.05).
Sonuç: Diyaliz sonrası yorgunluk ve konfor düzeyi ortalamanın üzerindeydi. Diyaliz sonrası yorgunluk hastaların konforunu olumsuz etkilemektedir. Hastalarda iki diyaliz seansı arasında semptomların varlığı konforu azaltırken, diyaliz sonrası kan basıncının azalması konfor düzeyini artırdı. Hemodiyaliz tedavisi alan hastalarda diyaliz sonrası yorgunluk ve konfor hemşireler tarafından rutin olarak değerlendirilmelidir. Diyaliz sonrası yorgunluk hafife alınmamalıdır.
References
- Bilgiç. Ş., Pamuk Cebeci. S. (2022). Relationship between stressors and comfort level in hemodialysis patients. Archives of Health Science and Research, 9(2),105–109. doi:10.54614/ArcHealthSciRes.2022.21146
- Borzou. S. R., Anosheh. M., Mohammad. E., Kazemnejad. A. (2014). Patients’ perception of comfort facilitators during hemodialysis procedure: A qualitative study. Iranian Red Crescent Medical Journal, 16(7), e19055. doi.org:10.5812/ircmj.19055
- Bossola. M., Di Stasio. E., Giungi. S., Rosa. F., Tazza. L. (2015). Fatigue is associated with serum interleukin-6 levels and symptoms of depression in patients on chronic hemodialysis. Journal of Pain and Symptom Management, 49(3), 578–85. https://doi.org/10.1016/j.jpainsymman.2014.07.009
- Bossola. M., Marzetti. E., Di Stasio. E., Monteburini. T., Cenerelli. S., Mazzoli., …Vulpio. C. (2018). Prevalence and associated variables of post-dialysis fatigue: Results of a prospective multicentre study. Nephrology, 23(6), 552–58. https://doi.org/10.1111/nep.13059
- Bossola. M., Picca. A., Monteburini. T., Parodi. E., Santarelli. S., … Di Stasio. E. (2021). Postdialysis fatigue and survival in patients on chronic hemodialysis. Journal of Nephrology, 34(6), 2163–65.doi: 10.1007/s40620-021-01141-8.
- Bossola. M., Tazza. L. (2016). Postdialysis Fatigue: A frequent and debilitating symptom. Seminars in Dialysis, 29(3), 222–27. doi:10.1111/sdi.12468
- Bossola. M., Vulpio. C., Tazza. L. (2011). Fatigue in chronic dialysis patients. Seminars in Dialysis, 24(5), 550-55. doi:10.1111/j.1525-139X.2011.00956
- Boudiab. L. D., Kolcaba. K. (2015). Comfort theory: Unraveling the complexities of veterans’ health care needs. Advances in Nursing Science, 38(4), 270–78. doi:10.1097/ANS.0000000000000089
- Daugirdas J. T. (1993). Second generation logarithmic estimates of single-pool variable volume Kt/V: an analysis of error. Journal of the American Society of Nephrology, 4(5), 1205-13. doi:10.1681/ASN.V451205
- Debnath. S., Rueda. R., Bansal. S., Kasinath. B. S., Sharma. K., Lorenzo. C. (2021). Fatigue characteristics on dialysis and non-dialysis days in patients with chronic kidney failure on maintenance hemodialysis. BMC Nephrology, 22(1), 112. doi:10.1186/s12882-021-02314-0
- Dikmen. R. D., Aslan. H. (2020). Clinical Nephrology and renal care the effects of the symptoms experienced by patients receiving hemodialysis treatment on their comfort levels. Journal Of Clinical Nephrology and Renal Care, 6(60), 2–9.doi: 10.23937/2572-3286/1510060.
- Dubin. R. F., Teerlink. J. R., Schiller. N. B., Alokozai. D., Peralta. C. A., Johansen. K. L. (2013). Association of segmental wall motion abnormalities occurring during hemodialysis with post-dialysis fatigue. Nephrology Dialysis Transplantation, 28(10), 2580–85. doi:10.1093/ndt/gft097
- Elsayed. M. M., Zeid. M. M., Hamza O. M. R., Elkholy. N. M. (2022). Dialysis recovery time: associated factors and its association with quality of life of hemodialysis patients. BMC Nephrology, 23(1), 298. doi:10.1186/s12882-022-02926-0
- Estridge. K., Morris. D., Kolcaba. K., Winkelman. C. (2018). Comfort and fluid retention in adult patients receiving hemodialysis. Nephrology Nursing Journal, 45(1), 25–33.
- Gülay. T., Özdemir Eller. Ç., Ökdem. Ş., Akgün Çıtak. E. (2020). Hemodiyaliz hastalarında konfor düzeyinin incelenmesi. Hacettepe Üniversitesi Hemşirelik Fakültesi Dergisi, 7(2), 122–29. doi.:10.31125/hunhemsire.763155
- Joshwa. B.,Peters. R. M.,Malek. M. H., Yarandi. H. N., Campbell. M. L. (2020). Multiple Dimensions and Correlates of Fatigue in Individuals on Hemodialysis. Nephrology Nursing Journal : Journal of the American Nephrology Nurses’ Association, 47(3), 215–51. doi: 10.37526/1526-744x.2020.47.3.215.
- Kacaroǧlu Vicdan. A. (2020). The Effect of Training Given to hemodialysis patients according to the comfort theory. Clinical Nurse Specialist, 34(1), 30–7. doi: 10.1097/NUR.0000000000000495.
- Kang. H.,Chae. Y. (2021). Effects of integrated indirect forest experience on emotion, fatigue, stress and immune function in hemodialysis patients. International Journal of Environmental Research and Public Health, 18(4), 1–12. doi: 10.3390/ijerph18041701
- Kodama. H., Togari. T., Konno. Y., Tsuji. A., Fujinoki. A., Kuwabara. S., Inoue , T. (2020). A new assessment scale for postdialysis fatigue in hemodialysis patients. Renal Replacement Therapy, 6(1), 3-6. doi: 10.1186/s41100-019-0252-5.
- Kolcaba. K. (1994). A theory of holistic comfort for nursing. Journal of Advanced Nursing, 19(6), 1178–84.
- Li. H., Yin. J., Dong. Y., Tian., Z. (2023). Factors predicting postdialysis fatigue of maintenance hemodialysis
patients. Renal Replacement Therapy, 9(30),1-8. doi: 10.1186/s41100-023-00486-z
- McIntyre, C. W., Burton, J. O., Selby, N. M., Leccisotti, L., Korsheed, S., Baker, C. S., Camici, P. G. (2008). Hemodialysis-induced cardiac dysfunction is associated with an acute reduction in global and segmental myocardial blood flow. Clinical journal of the American Society of Nephrology, 3(1), 19–26. doi: 10.2215/CJN.03170707
- Melo. G. A. A., Aguiar. L. L., Silva. R. A., Quirino. G. da S., Pinheiro. A. K. B., Caetano. J. Á. (2019). Factors related to impaired comfort in chronic kidney disease patients on hemodialysis. Revista Brasileira de Enfermagem, 72(4), 889–95. doi: 10.1590/0034-7167-2018-0120
- Ozen. N., Aydin Sayilan. A., Bal Ozkaptan. B., Neves Sousa. C., Unver. V. (2021). The reliability and validity of the Turkish version of the postdialysis fatigue scale. International Journal of Clinical Practice, 75(11), e14871. doi:10.1111/ijcp.14871
- Özer. Z., Alkın Demir. C. (2022). Hemodiyaliz tedavisi alan hastalarda semptom ve konfor ilişkisi. Nefroloji Hemşireliği Dergisi, 1(17), 10–20. doi: 10.47565/ndthdt.2022.49.
- Provenzano. M.,Coppolino. G., Faga. T., Garofalo. C., Serra. R., Andreucci. M. (2019). Epidemiology of cardiovascular risk in chronic kidney disease patients: The real silent killer. Reviews in Cardiovascular Medicine, 20(4), 209–20. doi:10.31083/J.RCM.2019.04.548
- Registry of The Nephrology, Dialysis, and Transplatation (2021). Registry of the nephrology, dialysis and transplantation in Türkiye Registry 2022. Erişim tarihi 25. Nisan 2023,https://nefroloji.org.tr/uploads/files/REGISTRY_2022.PDF
- Şahi̇n. Orak. N., Çinar Pakyüz. S., Kartal. A. (2017). Ölçek Geliştirme çalışması: hemodiyaliz hastalarında konfor. Nefroloji Hemşireliği Dergisi, 2(12), 68–77.
- Santos. R.C.D., Melo G.A.A, Silva. R.A., Silva. F.L.B.D., Viana Júnior. A.B., Caetano. J.Á. (2020). Relationship between the comfort level of chronic renal patients and sociodemographic and clinical variables. Revista Brasileira de Enfermagem, 73(5), e20200085. doi: 10.1590/0034-7167-2020-0085.
- Smokovska. N., Grozdanovski. R., Spasovski. G. (2015). Impact of different variables on recovery time in patients receiving hemodialysis. BANTAO Journal, 13(1), 20–24. https://doi.org/10.1515/bj-2015-0005
- Tabiee. S., Momeni. A. Saadatjoo. S. A. (2017). The effects of comfort-based ınterventions (Back massage and patient and family education) on the level of comfort among hemodialysis patients. Modern Care Journal, 14(3). e64687. doi:10.5812/modernc.64687
- You, Q., Bai. D. X., Wu. C. X., Chen. H., Hou. C. M., Gao. J. (2022). Prevalence and Risk Factors of Postdialysis Fatigue in Patients Under Maintenance Hemodialysis: A Systematic Review and Meta-Analysis. Asian Nursing Research, 16(5), 292–98. doi: 10.1016/j.anr.2022.11.002.
- Zadrazil. J., Horak. P. (2015). Pathophysiology of anemia in chronic kidney diseases: A review. Biomedical Papers, 159(2), 197–202. doi.:10.5507/bp.2013.093