Clin Nephrol. 2021 Nov;96(5):281-288. doi: 10.5414/CN110305.
Fatigue is a highly prevalent condition among people affected by chronic disease, with consequent poor health-related quality of life and lower survival rates. Fatigue is one of the most common and debilitating symptoms also experienced by hemodialysis (HD) patients after HD sessions, and given the non-specific manifestations and its invisible nature, it is under-recognized and under-treated by healthcare professionals. The complexity of fatigue's pathogenesis and the lack of measurement tools make the development of nursing interventions and practices specifically targeted at its recognition and therapy difficult. We aimed to investigate the prevalence and severity of fatigue, identify predictor variables in HD patients, and promote healthcare professionals' awareness and recognition of fatigue.
A single-center, cross-sectional study was conducted among 140 patients treated at the HD unit between August 2019 and March 2020 at the Nephrology, Dialysis, and Transplantation Unit of Padova University Hospital. We assessed patient's fatigue by Chalder's Fatigue Questionnaire, pain by Numeric Rating Scale and activities of daily living by Barthel Index. Demographic and clinical characteristics were taken from medical records.
The findings of this study indicate that age, dialysis vintage, inter-dialysis weight gain, and ultra-filtration rate are proportionally related to reported levels of fatigue. Hemoglobin, iron, ferritin, and number of sleep hours before HD session present a significant inverse correlation to fatigue.
The complexity of fatigue's pathogenesis makes a better understanding of this phenomenon difficult, nevertheless, healthcare professionals should develop interventions and practices targeted at its identification and management.
疲劳是慢性病患者中非常普遍的一种状况,会导致健康相关生活质量下降和生存率降低。疲劳是血液透析 (HD) 患者 HD 治疗后最常见和最虚弱的症状之一,由于其表现不明确且无形,因此医疗保健专业人员对其认识不足且治疗不足。疲劳发病机制的复杂性以及缺乏测量工具使得专门针对其识别和治疗的护理干预措施和实践的发展变得困难。我们旨在调查 HD 患者的疲劳发生率和严重程度,确定其预测变量,并提高医疗保健专业人员对疲劳的认识和识别。
2019 年 8 月至 2020 年 3 月期间,我们在帕多瓦大学医院肾脏病学、透析和移植科的 HD 病房进行了一项单中心、横断面研究,共纳入 140 名接受 HD 治疗的患者。我们使用 Chalder 疲劳问卷评估患者的疲劳程度,使用数字评分量表评估疼痛,使用巴氏指数评估日常生活活动能力。从病历中获取患者的人口统计学和临床特征。
本研究结果表明,年龄、透析时间、透析间期体重增加和超滤率与报告的疲劳水平成正比。血红蛋白、铁、铁蛋白和 HD 治疗前的睡眠时间与疲劳呈显著负相关。
疲劳发病机制的复杂性使得对这一现象的理解变得困难,但医疗保健专业人员应制定针对其识别和管理的干预措施和实践。