Advertisement

International Urology and Nephrology

, Volume 50, Issue 7, pp 1329–1339 | Cite as

Relationship between fatigue symptoms and subjective and objective indicators in hemodialysis patients

  • Manhua Zuo
  • Jun Tang
  • Miaomiao Xiang
  • Qing Long
  • Jianping Dai
  • Xiuying Hu
Nephrology - Original Paper
  • 91 Downloads

Abstract

Purpose

The purpose of the study was to investigate the major factors affecting fatigue symptoms and to examine the relationships between fatigue symptoms and subjective and objective indicators in patients on hemodialysis (HD).

Methods

Patients on HD who met the inclusion criteria were chosen from two grade A tertiary general hospitals by convenience sampling and cross-sectional survey methods.

Results

A total of 511 patients were included in the study. The morbidity rate of fatigue in patients on HD was 61.6%, and the median fatigue level was 3.91. Fatigue and subjective indicators showed a mild-moderate relationship (0.3 < all |r| < 0.6, all P < 0.001), whereas a weak correlation was found between fatigue and objective indicators (all |r| < 0.2, all P < 0.05). Multivariate analysis showed that subjective indicators, including employment, exercise time, appetite, the vitality of 36-item Short Form Health Survey, perceived social support, intrafamilial support, cramping, headache, chest tightness, and whole-body pain, as well objective indicator, such as serum intact parathyroid hormone levels, were the influence factors of fatigue in patients on HD.

Conclusion

The prevalence of fatigue symptoms was high and the level of fatigue was moderate in patients on HD. Subjective and objective indicators can both affect fatigue symptoms in patients on HD.

Keywords

Hemodialysis Fatigue Subjective indicator Objective indicator 

Notes

Acknowledgements

We thank hemodialysis staff of the two dialysis centers who granted us support of the overall study process. We are also grateful to Manhua Zuo’s doctoral advisor, Xiuying Hu, Professor MD, who supervised the study design. We also thank Jun Tang, Deputy Director of the Nephrology Department, who rigorously monitored extraction of the indicators and communication with patients throughout the process, as well as the research staff, including Jianping Dai, Qing Long, and Miaomiao Xiang, who assisted in data collection and management. This research received funding from the Young and Middle-Aged Talents Project in Hubei Provincial Department of Education (Q20161905).

Compliance with ethical standards

Conflict of interest

All authors declare no conflicts of interest.

Supplementary material

11255_2018_1871_MOESM1_ESM.docx (18 kb)
Supplementary material 1 (DOCX 17 KB)
11255_2018_1871_MOESM2_ESM.docx (16 kb)
Supplementary material 2 (DOCX 16 KB)

References

  1. 1.
    Collins AJ, Kasiske B, Herzog C, Chavers B, Foley R, Gilbertson D et al (2005) USRDS 2005 annual data report: atlas of end stage renal disease in the United States. Am J Kidney Dis 45:A5–A7, S1-280.CrossRefGoogle Scholar
  2. 2.
    Jhamb M, Argyropoulos C, Steel JL, Plantinga L, Wu AW, Fink NE et al (2009) Correlates and outcomes of fatigue among incident dialysis patients. Clin J Am Soc Nephrol 4:1779CrossRefPubMedPubMedCentralGoogle Scholar
  3. 3.
    Bonner A, Wellard S, Caltabiano M (2010) The impact of fatigue on daily activity in people with chronic kidney disease. J Clin Nurs 19:3006–3015CrossRefPubMedGoogle Scholar
  4. 4.
    Murtagh FEM, Addington-Hall J, Higginson IJ (2007) The prevalence of symptoms in end-stage renal disease: a systematic review. Adv Chronic Kidney Dis 14:82CrossRefPubMedGoogle Scholar
  5. 5.
    Curtin RB, Bultman DC, Thomashawkins C, Walters BA, Schatell D (2002) Hemodialysis patients’ symptom experiences: effects on physical and mental functioning. Nephrol Nurs J 29:567–574Google Scholar
  6. 6.
    Jhamb M, Weisbord SD, Steel JL, Unruh M (2008) Fatigue in patients receiving maintenance dialysis: a review of definitions, measures, and contributing factors. Am J Kidney Dis 52:353–365CrossRefPubMedPubMedCentralGoogle Scholar
  7. 7.
    Yu IC, Huang JY, Tsai YF (2012) Symptom cluster among hemodialysis patients in Taiwan. Appl Nurs Res 25:190–196CrossRefPubMedGoogle Scholar
  8. 8.
    Zhang H, Lu Q, Wen C, Yin L, Gu Z. (2011) Fatigue and related psychosocial factors in Hemodialysis Patients. Chin Nurs Manag 11Google Scholar
  9. 9.
    Hidenori Koyama SF, Tetsuo Shoji M, Inaba Y, Tsujimoto T, Tabata S, Okuno et al (2010) Fatigue is a predictor for cardiovascular outcomes in patients undergoing hemodialysis. Clin J Am Soc Nephrol 5:659CrossRefPubMedPubMedCentralGoogle Scholar
  10. 10.
    Bossola M, Luciani G, Tazza L (2009) Fatigue and its correlates in chronic hemodialysis patients. Blood Purif 28:245–252CrossRefPubMedGoogle Scholar
  11. 11.
    Bonner A, Wellard S, Caltabiano M (2008) Levels of fatigue in people with ESRD living in far North Queensland. J Clin Nurs 17:90–98PubMedGoogle Scholar
  12. 12.
    Liu HE (2006) Fatigue and associated factors in hemodialysis patients in Taiwan. Res Nurs Health 29:40–50CrossRefPubMedGoogle Scholar
  13. 13.
    RN DOSM (2007) An exploration of the relationship between fatigue and physical functioning in patients with end stage renal disease receiving haemodialysis. J Clin Nurs 16:276–284CrossRefGoogle Scholar
  14. 14.
    Piper BF, Dibble SL, Dodd MJ, Weiss MC, Slaughter RE, Paul SM et al (1998) The revised Piper Fatigue Scale: psychometric evaluation in women with breast cancer. Oncol Nurs Forum 25:677–684PubMedGoogle Scholar
  15. 15.
    Reeve BB, Stover AM, Alfano CM, Smith AW, Ballard-Barbash R, Bernstein l et al (2012) The Piper Fatigue Scale-12 (PFS-12): psychometric findings and item reduction in a cohort of breast cancer survivors. Breast Cancer Res Treat 136:9–20CrossRefPubMedPubMedCentralGoogle Scholar
  16. 16.
    Zigmond AS, Snaith RP (1983) The hospital anxiety and depression scale 2. Acta Psychiatr Scand 67(6):361–370CrossRefGoogle Scholar
  17. 17.
    Buysse DJ, Rd RC, Monk TH, Berman SR, Kupfer DJ (1989) The Pittsburgh Sleep Quality Index: a new instrument for psychiatric practice and research. Psychiatry Res 28:193–213CrossRefPubMedGoogle Scholar
  18. 18.
    Dahlem NW, Zimet GD, Walker RR (1991) The Multidimensional Scale of Perceived Social Support: a confirmation study. J Clin Psychol 47:756–761CrossRefPubMedGoogle Scholar
  19. 19.
    Jiang M, Li L (2003) Psychological tests of The Multidimensional Scale of Perceived Social Support: a confirmation study in hemodialysis patients. Chin J Behav Med Sci 12:31–33Google Scholar
  20. 20.
    Li L, Wang H, Shen Y (2002) Development and psychometric tests of a Chinese version of the SF-36 Health Survey Scales. Chin J Prev Med 36:109–113Google Scholar
  21. 21.
    She Y (2007) Study on the effect of self-management of hemodialysis patients management on their health. Tianjin Medical University, TianjinGoogle Scholar
  22. 22.
    Meuwese CL, Carrero JJ, Stenvinkel P (2011) Recent insights in inflammation-associated wasting in patients with chronic kidney disease. Contrib Nephrol 171:120–126CrossRefPubMedGoogle Scholar
  23. 23.
    Davis MP, Walsh D (2010) Mechanisms of fatigue. J Support Oncol 8:164PubMedGoogle Scholar
  24. 24.
    Chang WK, Hung KY, Huang JW, Wu KD, Tsai TJ (2001) Chronic fatigue in long-term peritoneal dialysis patients. Am J Nephrol 21:479–485CrossRefPubMedGoogle Scholar
  25. 25.
    Ossareh S, Roozbeh J, Krishnan M, Liakopoulos V, Bargman JM, Oreopoulos DG (2003) Fatigue in chronic peritoneal dialysis patients. Int Urol Nephrol 35:535–541CrossRefPubMedGoogle Scholar
  26. 26.
    Parfrey PS, Foley RN, Harnett JD, Kent GM, Murray D, Barre PE (1996) Outcome and risk factors of ischemic heart disease in chronic uremia. Kidney Int 49:1428–1434CrossRefPubMedGoogle Scholar
  27. 27.
    Brunier GM, Graydon J (1993) The influence of physical activity on fatigue in patients with ESRD on hemodialysis. ANNA J 20:457–461PubMedGoogle Scholar
  28. 28.
    Thong MS, Van DS, Noordzij M, Boeschoten EW, Krediet RT, Dekker FW et al (2009) Symptom clusters in incident dialysis patients: associations with clinical variables and quality of life. Nephrol Dial Transplant 24:225CrossRefPubMedGoogle Scholar
  29. 29.
    Ouzouni S, Kouidi E, Sioulis A, Grekas D, Deligiannis A (2009) Effects of intradialytic exercise training on health-related quality of life indices in haemodialysis patients. Clin Rehabil 23:53CrossRefPubMedGoogle Scholar
  30. 30.
    Gennari FJ (2001) Medical management of kidney and electrolyte disorders. Informa Healthcare, LondonGoogle Scholar
  31. 31.
    Carney RM, Mckevitt PM, Goldberg AP, Hagberg J, Delmez JA, Harter HR (1983) Psychological effects of exercise training in hemodialysis patients. Nephron 33:179CrossRefPubMedGoogle Scholar
  32. 32.
    O’Sullivan D, McCarthy G (2007) An exploration of the relationship between fatigue and physical functioning in patients with end stage renal disease receiving haemodialysis. J Clin Nurs 16:276–284CrossRefPubMedGoogle Scholar
  33. 33.
    McCann K, Boore JR (2000) Fatigue in persons with renal failure who require maintenance haemodialysis. J Adv Nurs 32(5):1132–1142CrossRefPubMedGoogle Scholar
  34. 34.
    Williams AG, Crane PB, Kring D (2007) Fatigue in African American women on hemodialysis. Nephrol Nurs J 34:610–617PubMedGoogle Scholar
  35. 35.
    Kim HR, Son GR (2005) Fatigue and its related factors in Korean patients on hemodialysis. Taehan Kanho Hakhoe chi 35:701PubMedGoogle Scholar

Copyright information

© Springer Science+Business Media B.V., part of Springer Nature 2018

Authors and Affiliations

  1. 1.West China Nursing School/West China HospitalSichuan UniversityChengduChina
  2. 2.School of MedicineHubei Institute for NationalitiesEnshiChina
  3. 3.Department of NephrologyThe Central Hospital of Enshi Autonomous PrefectureEnshiChina

Personalised recommendations