Department of Psychology, Catholic University of the Sacred Heart, Largo Gemelli, 1, 20123, Milan, Italy.
Research Unit in Affective and Social Neuroscience, Catholic University of the Sacred Heart, Milan, Italy.
BMC Psychol. 2019 Jul 23;7(1):49. doi: 10.1186/s40359-019-0321-0.
Nowadays there is a growing interest in exploring causes of fatigue symptoms and the possible linked aspects in patients with Chronic Kidney Disease (CKD) receiving hemodialysis (HD) treatment. Inflammatory processes were demonstrated to influence motivational systems functioning in chronic conditions. However, there is a lack of connection between quantitative motivational systems measure and patients self-report motivational and fatigue issue. Thus, the aim of this study was to identify an association between HD patients reward mechanisms, fatigue severity and psychosocial variables emerging from semi-structured interviews.
Interviews were held for a sample of ninety-four patients (54 males, 40 females; M = 62.98 ± 17.94; dialytic mean age in months = 76.55 ± 84.89) receiving chronic HD treatment and consequently analyzed by means of quantitative and qualitative analysis. Behavioral motivation systems reflecting inhibition/approach tendency to rewards were measured by Behavioral Inhibition/Activation System (BIS/BAS) scale and the fatigue severity experienced by HD patients was measured with the Fatigue Severity Scale. Scale results were correlated to psychosocial variables and topics derived from the semi-structured interviews.
Findings highlight the presence of two effects: one related to the Behavioral Activation System (BAS) as a protective factor against the HD treatment pervasive consequences; the other one deals with the self-reported levels of fatigue that seemed to significantly interfere with patients' daily life, as a function of gender.
Such results encourage the use of a mixed method approach to understand the complexity of the subjective experience of patients' facing chronic disease and treatments.
如今，人们越来越感兴趣地探索导致接受血液透析（HD）治疗的慢性肾脏病（CKD）患者出现疲劳症状的原因，以及可能与之相关的方面。炎症过程被证明会影响慢性疾病中动机系统的功能。然而，目前缺乏定量动机系统测量与患者自我报告的动机和疲劳问题之间的联系。因此，本研究的目的是确定 HD 患者奖励机制、疲劳严重程度和半结构化访谈中出现的心理社会变量之间的关联。
对 94 名患者（54 名男性，40 名女性；M=62.98±17.94；透析月龄平均值=76.55±84.89）进行了访谈，这些患者接受慢性 HD 治疗，随后进行了定量和定性分析。反映抑制/接近奖励倾向的行为动机系统通过行为抑制/激活系统（BIS/BAS）量表进行测量，HD 患者的疲劳严重程度通过疲劳严重程度量表进行测量。量表结果与心理社会变量和半结构化访谈中得出的主题相关联。
研究结果突出了两种效应的存在：一种与行为激活系统（BAS）有关，作为对抗 HD 治疗普遍后果的保护因素；另一种与自我报告的疲劳水平有关，这似乎与患者的日常生活有显著的干扰，这与性别有关。
这些结果鼓励使用混合方法来理解患者面对慢性疾病和治疗的主观体验的复杂性。
