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.
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)
Destekleyen Kurum
There was not financial support
Proje Numarası
no
Teşekkür
We would like to thank all healthcare professionals working in the dialysis center where the study was conducted, and patients participating in the study.
Kaynakça
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.
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
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
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.
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.
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
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
Özdemir, Ö. (2024). Postdialysis Fatigue and Comfort Levels of Patients Receiving Hemodialysis Treatment. Bandırma Onyedi Eylül Üniversitesi Sağlık Bilimleri Ve Araştırmaları Dergisi, 6(2), 356-365. https://doi.org/10.46413/boneyusbad.1439000
AMA
Özdemir Ö. Postdialysis Fatigue and Comfort Levels of Patients Receiving Hemodialysis Treatment. Bandırma Onyedi Eylül Üniversitesi Sağlık Bilimleri ve Araştırmaları Dergisi. Ağustos 2024;6(2):356-365. doi:10.46413/boneyusbad.1439000
Chicago
Özdemir, Özlem. “Postdialysis Fatigue and Comfort Levels of Patients Receiving Hemodialysis Treatment”. Bandırma Onyedi Eylül Üniversitesi Sağlık Bilimleri Ve Araştırmaları Dergisi 6, sy. 2 (Ağustos 2024): 356-65. https://doi.org/10.46413/boneyusbad.1439000.
EndNote
Özdemir Ö (01 Ağustos 2024) Postdialysis Fatigue and Comfort Levels of Patients Receiving Hemodialysis Treatment. Bandırma Onyedi Eylül Üniversitesi Sağlık Bilimleri ve Araştırmaları Dergisi 6 2 356–365.
IEEE
Ö. Özdemir, “Postdialysis Fatigue and Comfort Levels of Patients Receiving Hemodialysis Treatment”, Bandırma Onyedi Eylül Üniversitesi Sağlık Bilimleri ve Araştırmaları Dergisi, c. 6, sy. 2, ss. 356–365, 2024, doi: 10.46413/boneyusbad.1439000.
ISNAD
Özdemir, Özlem. “Postdialysis Fatigue and Comfort Levels of Patients Receiving Hemodialysis Treatment”. Bandırma Onyedi Eylül Üniversitesi Sağlık Bilimleri ve Araştırmaları Dergisi 6/2 (Ağustos 2024), 356-365. https://doi.org/10.46413/boneyusbad.1439000.
JAMA
Özdemir Ö. Postdialysis Fatigue and Comfort Levels of Patients Receiving Hemodialysis Treatment. Bandırma Onyedi Eylül Üniversitesi Sağlık Bilimleri ve Araştırmaları Dergisi. 2024;6:356–365.
MLA
Özdemir, Özlem. “Postdialysis Fatigue and Comfort Levels of Patients Receiving Hemodialysis Treatment”. Bandırma Onyedi Eylül Üniversitesi Sağlık Bilimleri Ve Araştırmaları Dergisi, c. 6, sy. 2, 2024, ss. 356-65, doi:10.46413/boneyusbad.1439000.
Vancouver
Özdemir Ö. Postdialysis Fatigue and Comfort Levels of Patients Receiving Hemodialysis Treatment. Bandırma Onyedi Eylül Üniversitesi Sağlık Bilimleri ve Araştırmaları Dergisi. 2024;6(2):356-65.