Alshammari Bushra, Edison J Silvia, Alkubati Sameer A, Alrasheeday Awatif M, Albagawi Bander, Alharbi Laila Lafi, Motakef Hajer I, Alshammari Layla, Siam Bahia Galal Abd El-Razik, Alharbi Nawal Abdullah, Assiri Wejdan, Almoqad Amirah Abdulaziz, Aldibas Abdulrahman Ibrahim, Alshammari Farhan
Medical Surgical Nursing Department, College of Nursing, University of Hail, Hail, Saudi Arabia.
Nursing Administration Department, College of Nursing, University of Hail, Hail, Saudi Arabia.
Front Public Health. 2025 Jul 9;13:1580689. doi: 10.3389/fpubh.2025.1580689. eCollection 2025.
End-stage renal disease (ESRD) patients undergoing hemodialysis (HD) often experience a substantial symptom burden, which negatively impacts their quality of life. While pharmacological treatments are commonly used to manage these symptoms, non-pharmacological interventions, such as exercise, have gained attention for their potential to alleviate both physical and psychological symptoms without additional medication-related side effects. Compared to other strategies that often target a limited range of symptoms-such as meditation for depression or music therapy for anxiety-exercise offers broader benefits, making it particularly promising for patients receiving HD.
This study aimed to evaluate the effectiveness of an exercise intervention in reducing the symptom burden among patients receiving HD in Hail City, Saudi Arabia.
A quasi-experimental pre-post intervention design was employed, involving (n = 72) HD patients recruited through convenience sampling from King Salman Specialist Hospital and King Khalid Hospital. Participants engaged in a structured exercise program for 12 weeks, with sessions conducted three times per week for 30 min. Symptom severity was assessed using the Dialysis Symptom Index (DSI) before and after the intervention. Data were analyzed using paired t-tests, with a significance level set at < 0.05.
A total of 72 HD patients participated in the study. The exercise intervention led to a statistically significant reduction in overall symptom severity scores, decreasing from 105.94 ± 9.77 pre-intervention to 102.50 ± 9.61 post-intervention ( < 0.001). Significant improvements were noted in multiple symptoms, including constipation ( = 0.002), decreased appetite (p < 0.001), restless legs ( = 0.001), fatigue ( < 0.001), joint pain ( = 0.045), difficulty concentrating ( = 0.045), and several emotional symptoms such as worrying ( = 0.024), nervousness ( = 0.002), trouble sleeping ( < 0.05), and feelings of sadness ( < 0.001). Sociodemographic factors, including younger age, female gender, shorter dialysis duration, and higher comorbidity burden, were significantly associated with greater baseline symptom severity.
The findings demonstrate that a structured exercise program is an effective non-pharmacological intervention for reducing symptom burden among HD patients. These results support incorporating exercise into routine HD care to enhance patient well-being. Future initiatives should focus on integrating supervised, accessible exercise programs into dialysis centers to maximize adherence and therapeutic benefit.
接受血液透析（HD）的终末期肾病（ESRD）患者常常承受着巨大的症状负担，这对他们的生活质量产生负面影响。虽然药物治疗常用于管理这些症状，但非药物干预措施，如运动，因其在不产生额外药物相关副作用的情况下减轻身体和心理症状的潜力而受到关注。与其他通常针对有限范围症状的策略（如用于治疗抑郁症的冥想或用于治疗焦虑症的音乐疗法）相比，运动具有更广泛的益处，这使其对接受HD治疗的患者特别有前景。
本研究旨在评估运动干预对沙特阿拉伯海勒市接受HD治疗的患者减轻症状负担的有效性。
采用准实验性干预前后设计，纳入通过便利抽样从沙特国王萨勒曼专科医院和哈立德国王医院招募的（n = 72）名HD患者。参与者参加为期12周的结构化运动计划，每周进行3次，每次30分钟。在干预前后使用透析症状指数（DSI）评估症状严重程度。使用配对t检验分析数据，显著性水平设定为<0.05。
共有72名HD患者参与了研究。运动干预使总体症状严重程度得分在统计学上显著降低，从干预前的105.94±9.77降至干预后的102.50±9.61（<0.001）。多种症状有显著改善，包括便秘（=0.002）、食欲减退（p<0.001）、不安腿综合征（=0.001）、疲劳（<0.001）、关节疼痛（=0.045）、注意力不集中（=0.045），以及一些情绪症状，如担忧（=0.024）、紧张（=0.002）、睡眠困难（<0.05）和悲伤情绪（<0.001）。社会人口统计学因素，包括年龄较小、女性、透析时间较短和合并症负担较重，与更高的基线症状严重程度显著相关。
研究结果表明，结构化运动计划是减轻HD患者症状负担的有效非药物干预措施。这些结果支持将运动纳入常规HD护理以提高患者福祉。未来的举措应侧重于将有监督、可及的运动计划纳入透析中心，以最大限度地提高依从性和治疗效益。
