Department of Internal Nursing, School of Health Sciences in Katowice, Medical University of Silesia, 40-752 Katowice, Poland.
Department of Internal Medicine and Metabolic Diseases, School of Health Sciences in Katowice, Medical University of Silesia, 40-752 Katowice, Poland.
Int J Environ Res Public Health. 2021 Nov 14;18(22):11952. doi: 10.3390/ijerph182211952.
Metabolic syndrome (MS) and anxiety disorders are common problems among hemodialysis patients (HD). However, there have been no studies defining the role of physical activity in reducing anxiety in HD patients with MS. This study was aimed to determine the effects on the severity of anxiety of a four-week rehabilitation program for HD patients, with or without metabolic syndrome (MS), planned and adapted to their abilities. The study was single-center, interventional, non-randomized, and prospective. Fifty-eight individuals completed the project (28 HD patients and 30 controls (C) with normal kidney function). Each group was divided into two subgroups with respect to MS. The mean age of the subjects in the HD and C groups was 56.9 ± 13.3 years (x¯ ± SD) and 61.5 ± 8.3 years (x¯ ± SD), respectively. Planned and adapted to the patient's abilities, the rehabilitation program based on physiotherapy was provided to each subject for 4 weeks. Baseline and post-intervention determined anxiety levels using the State-Trait Anxiety Inventory (STAI). The X1 scale tests state anxiety, and the X2 scale tests trait anxiety. Post-intervention, there was no significant difference in the intensity of state anxiety observed in HD patients compared to C with normal renal function, as observed before the program. After four weeks of regular physical activity planned and adapted to the patient's abilities in an inpatient ward, the level of state anxiety (X1) and trait anxiety (X2) lowered considerably in all HD patients (respectively: 35.1 ± 8.0 vs. 29.2 ± 5.0, = 0.001 for X1 and 41.8 ± 9.1 vs. 38.1 ± 5.9, = 0.008 for X2). The rehabilitation program significantly reduced the intensity of state anxiety (X1) in HD patients with MS (35.8 ± 7.9 vs. 29.2 ± 5.1; = 0.01). The rehabilitation program helped to significantly reduce the intensity of trait anxiety (X2) in HD patients without MS (41.9 ± 10.7 vs. 36.9 ± 5.9; = 0.04). Four-week physical activity planned and adapted to the patient's abilities reduces the intensity of anxiety in HD patients and controls with normal renal function. HD patients with MS benefit more in terms of reducing perceived state anxiety, and HD patients without MS in terms of reducing trait anxiety.
代谢综合征（MS）和焦虑症是血液透析患者（HD）常见的问题。然而，目前还没有研究定义身体活动在降低 MS 血液透析患者焦虑中的作用。本研究旨在确定四周康复计划对 HD 患者焦虑严重程度的影响，该计划针对 MS 为 HD 患者计划和适应他们的能力。该研究是单中心、干预性、非随机和前瞻性的。共有 58 人完成了该项目（28 名 HD 患者和 30 名肾功能正常的对照组（C））。每组根据 MS 分为两个亚组。HD 组和 C 组的受试者平均年龄分别为 56.9 ± 13.3 岁（x¯ ± SD）和 61.5 ± 8.3 岁（x¯ ± SD）。根据患者的能力，为每位患者提供基于物理治疗的康复计划，为期 4 周。使用状态特质焦虑量表（STAI）在基线和干预后确定焦虑水平。X1 量表测试状态焦虑，X2 量表测试特质焦虑。与干预前相比，HD 患者的状态焦虑强度在干预后与肾功能正常的 C 组相比没有显著差异。经过四周的定期身体活动，计划和适应患者的能力在住院病房，所有 HD 患者的状态焦虑（X1）和特质焦虑（X2）水平都显著降低（分别为：35.1 ± 8.0 vs. 29.2 ± 5.0，X1 为 0.001；41.8 ± 9.1 vs. 38.1 ± 5.9，X2 为 0.008）。康复计划显著降低了 MS 血液透析患者的状态焦虑强度（X1）（35.8 ± 7.9 vs. 29.2 ± 5.1；X1 为 0.01）。康复计划有助于显著降低无 MS 的 HD 患者特质焦虑（X2）的强度（41.9 ± 10.7 vs. 36.9 ± 5.9；X2 为 0.04）。计划和适应患者能力的四周身体活动可降低 HD 患者和肾功能正常对照组的焦虑强度。MS 血液透析患者在降低感知状态焦虑方面获益更多，而无 MS 的 HD 患者在降低特质焦虑方面获益更多。
