Hemodiyaliz Hastalarında Görülen Semptom Kümelerinin Cinsel İşlev ile İlişkisi

Öz

Amaç: Bu çalışma, hemodiyaliz hastalarında görülen semptom kümelerinin cinsel
işlev ile ilişkisini değerlendirmek amacıyla yapılmıştır.
Gereç ve Yöntem: Aynı ildeki iki devlet hastanesinin diyaliz merkezlerinde
hemodiyaliz tedavisi alan 116 hasta ile yapılan çalışma, tanımlayıcı-ilişkisel
tiptedir. Araştırmanın verileri, Tanıtıcı Bilgi Formu, Diyaliz Semptom İndeksi ve
Arizona Cinsel Yaşantılar Ölçeği ile elde edilmiştir. Hemodiyaliz hastalarının
cinsel işlev bozukluğunu etkileyen belirleyicilerin ilişkisini değerlendirmek için
tanımlayıcı istatistikler, faktör analizi ve Lineer regresyon analizi yapılmıştır.
Bulgular: Hastaların %95’inde cinsel işlev bozukluğu olduğu belirlenmiştir.
Hastalarda görülen semptom kümelerinin belirlenmesi için yapılan faktör
analizinde semptomlar sekiz küme altında toplanmıştır. İkinci semptom kümesi
(uykuya dalmada zorluk, uykuyu sürdürmede zorlanma, rahatsız hissetme, nefes
darlığı) semptomlarını yaşama ve hala sigara kullanma ile cinsel işlev
yetersizliğinin ilişkisi olduğu belirlenmiştir.
Sonuç: Hastaların tamamına yakınında cinsel işlev bozukluğu olduğu ve semptom
yönetiminde destekleyici yöntemlere gereksinimleri olduğu belirlenmiştir. Ayrıca,
uykusuzluk, nefes darlığı, rahatsızlık hissi semptomlarının cinsel işlev bozukluğu
ile ilişkili olduğu sonucuna ulaşılmıştır.

Anahtar Kelimeler

• Hemodiyaliz
• Cinsel İşlev Bozukluğu
• Semptom Kümesi

Relationship Between Symptom Clusters and Sexual Function in Hemodialysis Patients

Öz

Objective: This study was conducted to evaluate the relationship between
symptom clusters and sexual function seen in hemodialysis patients.
Material and Method: The study conducted with 117 patients who received
hemodialysis treatment in the dialysis center of two state hospitals is descriptive-
relational. The data of the study were obtained through the Descriptive
Characteristic Form, Dialysis Symptom Index, and Arizona Sexual Experience
Scale (ACYÖ). Descriptive statistics, factor analysis, and Linear regression
analysis were performed to evaluate the relationship of the determinants affecting
sexual dysfunction in hemodialysis patients.
Results: It was determined that 95.1% of the patients had sexual dysfunction. In
the factor analysis performed to determine the symptom clusters seen in the
patients, the symptoms were collected under 8 clusters. II. It has been determined
that there is a relationship between the symptoms cluster (difficulty falling asleep,
difficulty in maintaining sleep, feeling uncomfortable, shortness of breath) and
still smoking and sexual dysfunction
Conclusion: It was determined that almost all of the patients had sexual
dysfunction and they needed supportive methods in symptom management. Also,
it was concluded that the symptoms of insomnia, shortness of breath, discomfort
are associated with sexual dysfunction.

Anahtar Kelimeler

• Hemodialysis
• Symptom
• Symptom Cluster
• Sexual Dysfunction

Kaynakça

1. 1. Kara B. One of the priority issues in patients with end‐stage renal failure undergoing hemodialysis: Quality of life. TAF Preventive Medicine Bulletin. 2012; 11: 631–8.
2. 2. Eckardt KU, Coresh J, Devuyst O, Johnson RJ, Kottgen A, Levey AS, et al. Evolving importance of kidney disease: from subspecialty to global health burden. Lancet. 2013; 382 (9887): 158-69.
3. 3. Griva K, Davenport A, Harrison M, Newman S. An evaluation of illness, treatment perceptions, and depression in hospital- vs. home-based dialysis modalities. J Psychosom Res. 2010; 69(4): 363-70.
4. 4. Yılmaz Karabulutlu E, Okanlı A. Hemodiyaliz hastalarında hastalık algısının değerlendirilmesi. Anadolu Hemşirelik ve Sağlık Bilimleri Dergisi. 2011; 14(4).
5. 5. Charlot A, deRoux S. Biting through an arteriovenous hemodialysis graft: an unusual method of suicide. J Forensic Sci. 2009; 54(6): 1456-7.
6. 6. Keskin G, Babacan Gumus A, Tasdemir Yigitoglu G. Sexual dysfunctions and related variables with sexual function in patients who undergo dialysis for chronic renal failure. J Clin Nurs. 2019; 28(1-2): 257-69.
7. 7. Woloski-Wruble AC, Oliel Y, Leefsma M, Hochner-Celnikier D. Sexual activities, sexual and life satisfaction, and successful aging in women. J Sex Med. 2010; 7(7): 2401-10.
8. 8. Doss F, Polaschek N. Assessing sexual dysfunction in people living on dialysis in a New Zealand renal service. Ren Soc Aust J. 2012; 8 (3): 104-8.

9. 9. Göriş S, Bilgi N. Son dönem böbrek yetmezliği olan hastalarda cinsel fonksiyon bozukluğu ve hemşirelik bakımı. . Nefroloji Hemşireliği Dergisi. 2015; 10(1): 68-74.
10. 10. Aribi L, Masmoudi R, Ben Houidi A, Charfeddine F, Jarraya F, Hachicha J, et al. [Sexual disorder in hemodialysis patients]. Tunis Med. 2015; 93(2): 79-84.
11. 11. Barroso LV, Miranda EP, Cruz NI, Medeiros MA, Araújo AC, Mota Filho FH, et al. Analysis of sexual function in kidney transplanted men. Transplantation Proceedings Transplantasyon Bildirileri. 2008; 40: 3489–91.
12. 12. Prescott L, Eidemak I, Harrison AP, Molsted S. Sexual dysfunction is more than twice as frequent in Danish female predialysis patients compared to age‐ and gender‐matched healthy controls. International Urology and Nephrology. 2014; 46: 979-84. .
13. 13. Mustafa R, Schmidt RJ. Sexual dysfunction in dialysis patients: A review. . Austin Journal of Nephrology and Hypertension. 2015; 2(1): 1-7.
14. 14. Küçük L, Türkmen A, Küçük M. Sexual dysfunction in women after renal transplantation. . Sex Disabil. 2013; 31: 155– 66.
15. 15. Amro A, Waldum B, Dammen T, Miaskowski C, Os I. Symptom clusters in patients on dialysis and their association with quality-of-life outcomes. Journal of Renal Care. 2014; 40(1): 23-33.
16. 16. Cabrera V, Hansson J, Kliger A, Finkelstein F. Symptom Management of the Patient with CKD: The Role of Dialysis. Clin J Am Soc Nephrol. 2017; 12(4): 687-93.
17. 17. Solano J, Gomes B, Higginson I. A comparison of symptom prevalence in far advanced cancer, AIDS, heart disease, chronic obstructive pulmonary disease and renal disease. J Pain Symptom Manage. 2006; 31: 58-69.
18. 18. Akgöz N, Arslan S. Examination of Symptoms in Patients Who are on Hemodialysis Treatment. Türk Nefroloji, Diyaliz ve Transplantasyon Hemşireleri Derneği Nefroloji Hemşireliği Dergisi. 2017; 12(1): 20-8.
19. 19. Davison S, Jhangri G, Johnson J. Cross-sectional validity of a modified Edmonton symptom assessment system in dialysis patients: a simple assessment of symptom burden. Kidney Int 2006; 69(9): 1621-5.
20. 20. Göriş S, Ceyhan Ö, Taşcı S, Doğan N. Do Symptoms Related to Hemodialysis Affect Marital Adjustment? Sex Disabil. 2016; 34: 63-73.
21. 21. Hintistan S, Deniz A. Evaluation of Symptoms in Patients Undergoing Hemodialysis. Bezmialem Science. 2018; 6: 112-8.
22. 22. Raj R, Ahuja K, Frandsen M, Jose M. Symptoms and their recognition in adult haemodialysis patients: Interactions with quality of life. Nephrology. 2017; 22(3): 228-33.
23. 23. Bossola M, Pepe G, Picca A, Calvani R, Marzetti E. Treating symptoms to improve the quality of life in patients on chronic.Hemodialysis.International Urology and Nephrology. 2019; 51: 885–7
24. 24. Daugirdas J. Second generation logarithmic estimates of single-pool variable volume Kt/V: an analysis of error. J Am Soc Nephrol. 1993; 4: 1205.
25. 25. EL-Sheikh M, El Ghazaly G. Assessment of hemodialys adequacy in patients with chronic kidney disease in the hemodialysis unit at Tanta University Hospital in Egypt. Indian J Nephrol. 2016; 26(6): 398-404.
26. 26. Soykan A. The reliability and validity of Arizona sexual experiences scale in Turkish ESRD patients undergoing hemodialysis. . Int J Impot Res. 2004; 16: 531-4.
27. 27. Weisbord SD, Fried LF, Arnold RM, Fine MJ, Levenson DJ, Peterson RA, et al. Prevalence, severity, and importance of physical and emotional symptoms in chronic hemodialysis patients. J Am Soc Nephrol. 2005; 16(8): 2487-94.
28. 28. Önsöz HB, Usta Yeşilbalkan Ö. Reliability and validity of the turkish version of the dialysis symptom index in chronic hemodialysis patients. . Turkish Nephrology, Dialysis and Transplantation Journal. 2013; 22(1): 60-7.
29. 29. Jablonski A. The multidimensional characteristics of symptoms reported by patients on hemodialysis. Nephrol Nurs J. 2007; 34(1): 29-37.
30. 30. Özdemir Ç. Diyaliz Tedavisi alan hastalarda semptom kümelerinin belirlenmesi [Yüksek Lisans]. Ankara: Başkent Üniversitesi; 2011.
31. 31. Thong MS, van Dijk S, Noordzij M, Boeschoten EW, Krediet RT, Dekker FW, et al. Symptom clusters in incident dialysis patients: associations with clinical variables and quality of life. Nephrol Dial Transplant. 2009; 24(1): 225-30.
32. 32. Yu IC, Huang JY, Tsai YF. Symptom cluster among hemodialysis patients in Taiwan. Appl Nurs Res. 2012; 25(3): 190-6.
33. 33. Weisbord SD, Bossola M, Fried LF, Giungi S, Tazza L, Palevsky PM, et al. Cultural comparison of symptoms in patients on maintenance hemodialysis. Hemodial Int. 2008; 12(4): 434-40.
34. 34. Sabanciogullari S, Taşkın Yılmaz F, İlke Güngör F, Söylemez S, B. BR. Sexual Function in Patients with Chronic Renal Failure on Hemodialysis and Its Effects on Patients’ Perception of Health and Life Satisfaction. Sexuality and Disability. 2015; 33: 185-6.
35. 35. Finkelstein FO, Shirani S, Wuerth D, Finkelstein SH. Therapy Insight: sexual dysfunction in patients with chronic kidney disease. Nat Clin Pract Nephrol. 2007; 3(4): 200-7.
36. 36. Martin-Diaz F, Reig-Ferrer A, Ferrer-Cascales R. [Sexual function and quality of life in hemodialysis male patients]. Nefrologia. 2006; 26(4): 452-60.
37. 37. Hui DS, Wong TY, Ko FW, Li TS, Choy DK, Wong KK, et al. Prevalence of sleep disturbances in chinese patients with end-stage renal failure on continuous ambulatory peritoneal dialysis. Am J Kidney Dis. 2000; 36(4): 783-8.
38. 38. Parker KP, Bliwise DL, Bailey JL, Rye DB. Daytime sleepiness in stable hemodialysis patients. Am J Kidney Dis. 2003; 41(2): 394-402.
39. 39. Novak M, Shapiro CM, Mendelssohn D, Mucsi I. Diagnosis and management of insomnia in dialysis patients. Semin Dial. 2006; 19(1): 25-31.
40. 40. Yang B, Xu J, Xue Q, Wei T, Xu J, Ye C, et al. Non-pharmacological interventions for improving sleep quality in patients on dialysis: systematic review and meta-analysis. Sleep Med Rev. 2015; 23: 68-82.
41. 41. Liebman SE, Lamontagne SP, Huang LS, Messing S, Bushinsky DA. Smoking in dialysis patients: a systematic review and meta-analysis of mortality and cardiovascular morbidity. Am J Kidney Dis. 2011; 58(2): 257-65.
42. 42. Longenecker JC, Coresh J, Klag MJ, Levey AS, Martin AA, Fink NE, et al. Validation of comorbid conditions on the end-stage renal disease medical evidence report: the CHOICE study. Choices for Healthy Outcomes in Caring for ESRD. J Am Soc Nephrol. 2000; 11(3): 520-9.
43. 43. Palamidas AF, Gennimata SA, Karakontaki F, Kaltsakas G, Papantoniou I, Koutsoukou A, et al. Impact of hemodialysis on dyspnea and lung function in end stage kidney disease patients. Biomed Res Int. 2014; 2014: 212751.