The Experience and Self-Management Of Fatigue in Patients on Hemodialysis

James Madison University, Harrisonburg, VA, USA.
Nephrology nursing journal: journal of the American Nephrology Nurses' Association (Impact Factor: 0.62). 11/2012; 40(2):113-22; quiz 123.
Source: PubMed


Fatigue is a common and debilitating symptom for adult patients with end stage renal disease on hemodialysis, and has been associated with decreased survival and quality of life. Patients on hemodialysis must find ways to manage their fatigue and mitigate its effects on their lives. The purpose of this qualitative descriptive work was to describe the experience and self-management of fatigue in patients on incenter hemodialysis. Several themes were identified which included the nature of fatigue, management of fatigue, consequences of fatigue, and factors associated with fatigue. This information will be valuable to nephrology nurses as they continue to care for and educate patients on hemodialysis.

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    • "Dialysis patients experience numerous symptoms, among which, the prevalence rate of fatigue in haemodialysis patients is recorded as being high, with about 73Á7–91% of the patients experiencing this symptom (Yong et al. 2009, Gordon et al. 2011). Not only can fatigue negatively affect the daily lives and activities of patients (Bonner et al. 2010, Horigan et al. 2013) but it also impacts their quality of life, which will subsequently lead to feebleness, an increase in dependency on others , reduced physical and mental energy, fewer social interactions and increased depression (O'Sullivan & McCarthy 2009), thereby lowering a patient's overall quality of life (Jhamb et al. 2009, 2011). Koyama et al. (2010) reported that severely fatigued haemodialysis patients suffer a higher prelavance rate for cardiovascular diseases. "
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    ABSTRACT: To investigate the fatigue levels and important fatigue predictors for patients undergoing haemodialysis. Fatigue is a common symptom for haemodialysis patients. With its debilitating and distressing effects, it impacts patients in terms of their quality of life while also increasing their mortality rate. A descriptive correlational study. Convenience sampling was conducted at six chosen haemodialysis centres in Southern Taiwan. Data were collected via a structured questionnaire from 193 haemodialysis patients. The scales involved in this study were socio-demographic details, the Center for Epidemiologic Studies Depression Scale, and the Fatigue Scale for haemodialysis patients. Data analysis included percentages, means, standard deviations and hierarchical multiple regression analysis. The fatigue level for haemodialysis patients was in the moderate range. Results from the hierarchical multiple regression analysis indicated that age, employment status, types of medications, physical activity and depression were significant. Of those variables, depression had the greatest impact on the patients' fatigue level, accounting for up to 30·6% of the explanatory power. The total explanatory power of the regression model was 64·2%. This study determined that for haemodialysis patients, unemployment, increased age, taking more medications or lower exercise frequencies resulted in more severe depression, which translated in turn to higher levels of fatigue. Among all these factors, depression had the greatest impact on the patients' fatigue levels. Not only is this finding beneficial to future studies on fatigue as a source of reference, it is also helpful in our understanding of important predictors relating to fatigue in the everyday lives of haemodialysis patients. It is recommended that when caring for fatigued patients, more care should be dedicated to their psychological states, and assistance should be provided in a timely way so as to reduce the amount of fatigue suffered. © 2015 John Wiley & Sons Ltd.
    Full-text · Article · Mar 2015 · Journal of Clinical Nursing
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    ABSTRACT: Fatigue is commonly experienced in patients with advanced kidney disease and associated with poor outcomes. The prevalence of fatigue ranges from 42% to as high as 89% according to treatment modality and the measurement instruments used. This paper reviews studies examining sociodemographic, biological, and psychological factors associated with fatigue in advanced kidney disease. The association between fatigue and psychological factors, such as depression and anxiety, behavioral factors, such as sleep and nutrition, and cytokines, such as IL-6 and CRP corroborates the view of fatigue as a multidimensional and multifactorial problem. Although depression and fatigue are related, the relationship is typically moderate in size, thus fatigue should not simply be seen as a symptom of distress. Accordingly, it is important for treatment plans to address the complex etiology of fatigue through pharmacological and nonpharmacological interventions. To date, results of nonpharmacological interventions are promising, with physical exercise and cognitive-behavioral therapy showing beneficial results. Work conducted in other patient populations highlights the importance of cognitions and behaviors in the prediction and maintenance of fatigue. Such work could be applied to advanced kidney disease allowing a model of fatigue to be developed from which to base suitable interventions in this setting.Kidney International advance online publication, 2 April 2014; doi:10.1038/ki.2014.86.
    No preview · Article · Apr 2014 · Kidney International
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    ABSTRACT: Background:The patients receiving hemodialysis spend a lot of their lifetime in the hemodialysis departments, which is an unpleasant experience. Therefore, some interventions are necessary to relieve this experience.Objectives:The current study aimed to explore the hemodialysis patients' perceptions of comfort facilitators during the hemodialysis procedure.Patients and Methods:This study was conducted by a qualitative content analysis approach. Twenty four patients receiving hemodialysis participated in this study by purposive sampling. The sampling was over when the data saturation occurred. The semi-structured interviews were applied as the main data gathering tool. The data analysis was conducted by conventional qualitative content analysis in eight phases.Results:Three themes emerged: The presence of competent nurses, the delightful presence of the others, and coping with comfort obstacles. Each theme consisted of some categories.Conclusions:It seems that to achieve the patients' comfort during the hemodialysis procedure, the health care teams, hospitals in charge and the patients themselves have to do their best to provide the patients' comfort.
    Full-text · Article · Jul 2014
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