Hemodiyaliz Tedavisi Gören Hastalarda Ağrı Değerlendirmesi

Year 2021, Volume: 11 Issue: 6, 768 - 773, 20.11.2021

Şeyda Can Arzu Arda

https://doi.org/10.16899/jcm.920561

Abstract

Amaç: Hemodiyaliz (HD) tedavisi gören hastalarda ağrı sık görülen ve büyük ölçüde yaşam kalitesini etkileyen önemli bir sağlık problemidir. Bu araştırma, McGill Ağrı Anketi ile hemodiyaliz tedavisi gören hastaların kalitatif ağrı özelliklerini değerlendirmeyi amaçlamaktadır.
Gereç ve Yöntem: Araştırma, hemodiyaliz tedavisi gören 87 hasta ile gerçekleştirilen nicel, tanımlayıcı ve kesitsel bir çalışmadır. Veriler bilgi formu ve McGill Ağrı Anketi aracılığıyla 01.04.2019-31.09.2019 tarihleri arasında Türkiye’de bir eğitim araştırma hastanesinin hemodiyaliz kliniğinde toplandı.
Bulgular: Çalışmada HD hastalarının var olan ağrı şiddeti puan ortalamalarının orta düzeyde (2.13±0.56) olduğu belirlendi. Katılımcıların en sık alt ekstremite (%36.8), ve baş bölgesinde (%29.9) en az üst ekstremitede (%11.5) ağrı deneyimlediği saptandı. Hemodiyaliz işlemi (%44.8), diyete dikkat etmemek (%23), yorgunluk (%16.1) ve stresin (%16.1) ağrıyı artırdığı görüldü. Hastaların ağrısı olduğunda ise sırası ile analjeziklerin (%36.8), istirahat etmenin (%31), tamamlayıcı yaklaşımların (%17.2) ve diğer uygulamaların (%14.9) ağrıyı azalttığı belirlendi. Hastaların hissettikleri ağrıları tanımlarken sıklıkla yorucu (n=47), tiksindirici (n=42), korku veren (n=41) ve sefil eden (n=38) ifadelerini kullandığı görüldü.
Sonuç: Yaşam kalitesinin artırılmasında ağrıyı ölçmek ve karakterize etmek son derece önemlidir. Elde edilen sonuçların hemodiyaliz hastalarında, ağrıyı bireye özgü değerlendirerek bütüncül bir yaklaşımın sunulmasında yol gösterici olacağı düşünülmektedir.

Keywords

Ağrı, ağrı ölçümü, hemodiyaliz, McGill Pain Questionnaire

Supporting Institution

Bukunmamaktadır.

Pain Assessment In Patients Who Receive Hemodialysis Treatment

Abstract

Aim: Pain is an important health issue that is common among patients who receive hemodialysis (HD) treatment and greatly affects the patients’ quality of life. This study aims to assess the qualitative pain characteristics of patients who receive HD treatment using the McGill Pain Questionnaire.
Materials and Method: This quantitative, descriptive and cross-sectional study included 87 patients who received HD treatment. Data were collected using an information form and the McGill Pain Questionnaire in the HD clinic of a training and research hospital in Turkey between 01.04.2019 and 31.09.2019.
Results: The study found that the mean current pain scores of the HD patients were moderate (2.13±0.56). The study determined that the patients experienced pain most often in the lower extremity (36.8%) and head region (29.9%) and least in the upper extremity (11.5%). The hemodialysis procedure (44.8%), not following the diet (23%), fatigue (16.1%) and stress (16.1%) were found to intensify the pain. The study found that analgesics (36.8%), resting (31%), complementary approaches (17.2%) and other practices (14.9%) relieved pain when patients were in pain. The study also found that the patients often used the words tiring (n=47), sickening (n=42), fearful (n=41) and wretched (n=38) to define the pain they felt.
Conclusion: Measuring and categorizing pain are greatly important to increase the quality of life. The results obtained indicate that assessment of the pain individualistically will be a guide to provide a holistic approach in HD patients.

Keywords

Pain, pain measurement, hemodialysis, McGill Pain Questionnaire

References

• 1. Bikbov B, Perico N, Remuzzi G. Disparities in chronic kidney disease prevalence among males and females in 195 countries: Analysis of the global burden of disease 2016 study. Nephron 2018;139(4):313-318. https://doi.org/10.1159/000489897
• 2. Crews DC, Bello AK, Saadi G. 2019 World Kidney Day Editorial - burden, access, and disparities in kidney disease. J Bras Nefrol 2019;41(1):1–09. doi: 10.1590/2175-8239-JBN-2018-0224.
• 3. Şanlitürk D, Ovayolu N, Kes D. Common problems in hemodialysis patients and the problem solving recommendations. Journal of Nephrology Nursing 2018;1(13):17-25. (Original work published in Turkish). Retrieved from https://dergipark.org.tr/en/download/article-file/418873
• 4. Dąbrowska-Bender M, Dykowska G, Żuk W, Milewska M, Staniszewska A. The impact on quality of life of dialysis patients with renal insufficiency. Patient Preference and Adherence 2018;12:577–583. doi: 10.2147/PPA.S156356
• 5. Brkovic T, Burilovic E, Puljak L. Prevalence and severity of pain in adult end-stage renal disease patients on chronic intermittent hemodialysis: A systematic review. Patient Preference and Adherence 2016;22(10):1131–1150. doi: 10.2147/PPA.S103927.
• 6. Özyiğit S, Yıldırım Y, Karaman E. Pain in hemodialysis patients. Turk Neph Dial Transpl 2016;25(1):88-94. (Original work published in Turkish). doi: 10.5262/tndt.2016.1001.10
• 7. İtişgen V, Kara B. Pain management in hemodialysis patients. Journal of Nephrology Nursing 2016;2:1-8. (Original work published in Turkish). Retrieved from https://asosindex.com.tr/index.jsp?modul=articles-pdf&journal-id=15&articleid=1826
• 8. Hanoch Kumar K, Elavaras P. Definition of pain and classification of pain disorders. Journal of Advanced Clinical & Research Insights 2016;3:87–90. doi: 10.15713/ins.jcri.112
• 9. Miller LE, Eldredge SA, Dalton ED. “Pain is what the patient says it is’’:Nurse–patient communication, information seeking, and pain management. American Journal of Hospice & Palliative Medicine 2016;34(10):966-976. doi: 10.1177/1049909116661815.
• 10. Yeşil S, Karslı B, Kayacan N, Süleymanlar G, Ersoy F. Pain evaluation in patients with chronical renal failure undergoing hemodialysis. AGRI 2015;27(4):197-204. (Original work published in Turkish). doi: 10.5505/agri.2015.44712
• 11. Özveren H, Faydalı S, Gülnar E, Faydalı Dokuz H. Attitude and applications of nurses to evaluate pain. J Contemp Med 2018;8(1):60-66. (Original work published in Turkish). DOI: 10.16899/gopctd.388195.
• 12. Sadigova E, Ozkurt S, Yalcin A. Pain assessment in hemodialysis patients. Cureus 2020;12(2):e6903. DOI 10.7759/cureus.6903
• 13. Melzack R. The McGill Pain Questionnaire: major properties and scoring methods. Pain 1975;1:277-299. 10.1016/0304-3959(75)90044-5
• 14. Kuguoglu S, Aslan FE, Olgun N. The Turkish adaptation of the McGill Melzack pain questionnaire (MPQ). Pain 2003;15:47–51. (Original work published in Turkish).
• 15. San A, Hiremagalur B, Muircroft W, Grealish L. Screening of cognitive impairment in the dialysis population: A scoping review. Dement Geriatr Cogn Disord 2017;44:182–195. DOI: 10.1159/000479679
• 16. Tang EY, Amiesimaka O, Harrison SL, Green E, Price C, Robinson L, Siervo M, Stephan BC. Longitudinal Effect of Stroke on Cognition: A Systematic Review. Journal of the American Heart Association 2018;7(2):e006443. https://doi.org/10.1161/JAHA.117.006443 17. Kafkia T, Vehvilainen- Julkunen K, Sapountzi- Krepia D. Assessment and management of pain in hemodialysis patient: A pilot study. Progress in Health Sciences 2014;4(1):53-60.
• 18. Ghonemy TA, Allam HM, Elokely AM, Kadry YA, Omar HM. Chronic pain in hemodialysis patients: Role of bone mineral metabolism. Alexandria Journal of Medicine 2016;2(4):337-342. DOI: 10.1016/j.ajme.2015.12.002
• 19. Caravaca F, Gonzales B, Bayo MA, Luna E. Dolor músculo-esquelético en pacientes con enfermedad renalcrónica. Nefrologia 2016;36:433–440. http://dx.doi.org/10.1016/j.nefro.2016.03.024.
• 20. Özer Z, Bahçeci̇oğlu Turan G, Çeli̇kbi̇lek F. Relationship between pain beliefs and pain management in hemodialysis patients. Journal of Nephrology Nursing 2020;15(3):226-234. (Original work published in Turkish). DOI: 10.47565/ndthdt.2020.19
• 21. Bilgiç M, Duymaz T. An investigation of the effects of posture corrective exercise and stretch combination on flexibility pain and depression score in the late adolescence period. IGUSABDER 2018;4:318-329. (Original work published in Turkish). Retrieved from https://dergipark.org.tr/tr/pub/igusabder/issue/36402/393855
• 22. Kesikburun B, Ekşioğlu E, Akdağ İ, Çakçı A. Low back pain in hemodialysis patients: Risk factors and its impact on health-related quality of life. Turk J Phys Med Rehab 2018;64(1):66-71 DOI: 10.5606/tftrd.2018.1016.
• 23. Akça N, Arslan D. Pain and coping methods of individuals under 65 years of age on hemodialysis treatment. Turk Neph Dial Transpl 2015;24(3):278-282. (Original work published in Turkish). doi: 10.5262/tndt.2015.1003.04
• 24. González Oquendo, L, Morales Asencio JM, Bonill de las Nieves C. Contributing factors for therapeutic diet adherence in patients receiving haemodialysis treatment: an integrative review. J Clin Nurs 2017;26:3893– 3905. https://doi.org/10.1111/jocn.13804
• 25. Zins S, Hooke MC, Gross CR. Reiki for pain during hemodialysis: A feasibility and instrument evaluation study. Journal of Holistic Nursing 2019;37(2):148-162. doi:10.1177/0898010118797195
• 26. Holly M, Koncicki MU, Schell JO. Pain management in CKD: A guide for nephrology providers. American Journal of Kidney Diseases 2017;69(3):451-460. https://doi.org/10.1053/j.ajkd.2016.08.039.
• 27. Ruela Ludmila de Oliveira, Siqueira Yeda Maria Antunes de, Gradim Clícia Valim Côrtes. Pain evaluation in patients under chemotherapy: application of McGill pain Questionnaire. Revista Dor 2017;18(2):156-160. https://doi.org/10.5935/1806-0013.20170031
• 28. Barbosa IM, Sales DS, Oliveira LMS, Sampaio DV, Milhome AG. Pain in onco-hematologic patients and its association with analgesia. Rev Dor 2016;17(3):178-82. DOI 10.5935/1806-0013.20160066.
• 29. Fillingim RB. Individual differences in pain: understanding the mosaic that makes pain personal. Pain 2017;15(Suppl1):11–18.