Title: Fatigue is the predominant patient-reported outcome measure in hemodialysis patients: Results of a multicenter cross-sectional ePROMs Study (original) (raw)
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Patient-Reported Outcome Measures for Fatigue in Patients on Hemodialysis: A Systematic Review
American journal of kidney diseases : the official journal of the National Kidney Foundation, 2017
Fatigue is a prevalent and debilitating symptom in patients receiving hemodialysis. We aimed to identify and evaluate the characteristics and psychometric properties of patient-reported outcome measures for fatigue in patients receiving hemodialysis, to inform the selection of a robust and feasible measure for use in randomized trials in hemodialysis. Systematic review of outcome measures for fatigue. Patients receiving hemodialysis. MEDLINE, Embase, PsycINFO, and CINAHL from inception to April 2017 were searched for all studies that reported fatigue in patients receiving hemodialysis. With a focus on addressing methods, items (individual questions) from all measures were categorized into content and measurement dimensions of fatigue. We assessed the general characteristics (eg, number of items and cost) and psychometric properties of all measures. From 123 studies, we identified 43 different measures: 24 (55%) were developed specifically for the hemodialysis population (of which 18...
Assessment of quality of life and fatigue among haemodialysis patients
Abstract: Fatigue is one of the most common symptoms of haemodialysis patients and is associated with poor quality of life. Purpose: To investigate the levels of fatigue and its correlation with quality of life of haemodialysis patients. Results: Of the 134 haemodialysis patients, the majority of patients (52,9%) seemed to have low rates of fatigue (10 <FAS <= 20). However, 15% of these patients seemed to appear high to very high levels of fatigue (30 <FAS <= 50). Studying the quality of life of these patients we can observe a correlation between fatigue and quality of life. In particular , patients who experience higher rates of fatigue seem to have worse quality of life (MVQOLI total score 2.90) than those experiencing lower rates of fatigue (MVOQLI total score 3.67) (p <0,005). Conclusions: The analysis of the results enable us to understand the correlation between fatigue and quality of life among haemodialysis patients with ESRD and the importance of prevention, diagnosis and treatment of fatigue in order to optimize the quality of life in dialysis patients with ESRD. Keywords: Fatigue, Quality of Life, Chronic Kidney Disease, Haemodialysis, End Stage Renal Disease
American journal of kidney diseases : the official journal of the National Kidney Foundation, 2018
Fatigue is one of the most highly prioritized outcomes for patients and clinicians, but remains infrequently and inconsistently reported across trials in hemodialysis. We convened an international Standardized Outcomes in Nephrology-Hemodialysis (SONG-HD) consensus workshop with stakeholders to discuss the development and implementation of a core outcome measure for fatigue. 15 patients/caregivers and 42 health professionals (clinicians, researchers, policy makers, and industry representatives) from 9 countries participated in breakout discussions. Transcripts were analyzed thematically. 4 themes for a core outcome measure emerged. Drawing attention to a distinct and all-encompassing symptom was explicitly recognizing fatigue as a multifaceted symptom unique to hemodialysis. Emphasizing the pervasive impact of fatigue on life participation justified the focus on how fatigue severely impaired the patient's ability to do usual activities. Ensuring relevance and accuracy in measuri...
Factors Associated With Fatigue in Patients Undergoing Hemodialysis
Cureus, 2022
Background and objective Fatigue is frequently experienced by patients undergoing hemodialysis and it has a negative effect on their quality of life. The aim of this study was to investigate the factors associated with fatigue in patients undergoing hemodialysis. Methods In this quantitative cross-sectional study, 100 patients on hemodialysis participated. Fatigue was evaluated via the Modified Fatigue Impact Scale (MFIS). Participants also completed a questionnaire about demographics and clinical characteristics. The Kruskal-Wallis test, the Mann-Whitney U test, and Spearman's rho criterion were used to assess the association between fatigue score and patient characteristics. Multiple linear regression was performed to assess the effect of the characteristics on patients' fatigue. Results Statistically significant high levels of physical or mental fatigue were found in older patients (p=0.001 and p=0.001), divorced/widowed patients (p=0.001 and p=0.014), those who had children (p=0.019), those who had primary education (p=0.015), those who were not informed about their health problems (p=0.003 and p=0.006), those who had comorbid diseases (p=0.001 and p=0.001), those who believed that regular information did not help to reduce stress (p=0.005 and p=0.004), patients who had insomnia (p=0.001 and p=0.001), patients who felt tired after hemodialysis (p=0.001 and p=0.001), those who thought they had a change in body image (p=0.001 and p=0.001), those who often felt stiffness (p=0.001 and p=0.001), those who sometimes felt nausea (p=0.015 and p=0.038), and those who had limitations in the clothes they could wear (p=0.001 and p=0.001). Conclusions The findings of this study showed that physical or mental fatigue had a strong association with advanced age, comorbidities, marital status, level of education, inadequate information about the disease, insomnia, and change in body appearance. Hence, renal professionals need to properly educate dialysis patients on the complicated nature of fatigue in order to manage it effectively and improve their physical, cognitive, and social wellbeing.
Correlates and Outcomes of Fatigue among Incident Dialysis Patients
Clinical Journal of the American Society of Nephrology, 2009
Background & objectives: Fatigue is a debilitating symptom experienced by patients undergoing dialysis, but there is only limited information on its prevalence and its association with patient outcomes. This study examines the correlates of self-reported fatigue at initiation of dialysis and after 1 yr and assesses the extent to which fatigue was associated with health-related quality of life and survival.
Fatigue, anxiety, depression and sleep quality in patients undergoing haemodialysis
BMC Nephrology, 2021
Objective Patients undergoing haemodialysis may experience troubling symptoms such as fatigue, anxiety, depression and sleep quality, which may affect their quality of life. The main objective of this study is to determine the prevalence of fatigue, anxiety, depression and sleep quality among patients receiving haemodialysis during the coronavirus disease 2019 (COVID-19) pandemic, and to explore the contributing predictors. Methods A cross-sectional and descriptive correlational design using Qualtrics software was performed. Data were collected using the Functional Assessment of Cancer Therapy-Fatigue (FACT-F), the Hospital Anxiety and Depression Scale (HADS) and the Pittsburgh Sleep Quality Index (PSQI). Logistic regression analyses were used to explore the predictors that were associated with fatigue, anxiety, depression and sleep quality. Results Of the 123 patients undergoing haemodialysis who participated, 53.7% ( n = 66) reported fatigue, 43.9% ( n = 54) reported anxiety, 33...
Impact of Fatigue on Outcomes in the Hemodialysis (HEMO) Study
American Journal of Nephrology, 2011
Background: Fatigue is a common debilitating symptom in chronic kidney disease patients on maintenance hemodialysis. However, little is known about its pathogenesis and association with survival. Methods: This study examines the correlates and outcomes of fatigue among 1,798 hemodialysis patients enrolled in the HEMO study. Fatigue was assessed using the SF-36 vitality scale. Multivariable analysis was used to assess independent associations of demographic and clinical characteristics with baseline fatigue and longitudinal changes in fatigue. The association of fatigue with all-cause and cause-specific mortality and cardiac hospitalizations was also assessed. Results: Higher index of coexistent diseases (ICED) score, diabetes, non-African-American race, lower serum albumin, use of medications for sleep and poor sleep quality were found to be significantly associated with more fatigue at baseline. In longitudinal analyses, patients who were older, had been on dialysis longer, had hig...
Minutes to Recovery after a Hemodialysis Session
Clinical Journal of the American Society of Nephrology, 2006
Patients who have end-stage renal failure and are treated by hemodialysis (HD) face a stressful chronic illness with a demanding treatment regimen that affects quality of life. Quality-of-life domains can be measured by assessment questionnaires that are easy to complete, reliable, valid, and sensitive to change. There is current interest in HD regimens that provide more frequent treatments (e.g., daily) than the conventional thrice weekly. Improvement in quality of life by these regimens has been reported. A published prospective, cohort, controlled study (London Daily/Nocturnal Hemodialysis Study) included the results of a number of qualityof-life indicators that were applied to the study patients. In general, the indicators used were well established and of proven validity. Included was one single question that was added intuitively and had not received previous validation: "How long does it take you to recover from a dialysis session?" The responses to this question allow the validation of this simple question as a tool to be used in HD clinical research. Twenty-three patients who were treated by frequent HD (5 to 7 d or nights) and 22 control subjects who were treated by thrice-weekly dialysis were studied during an 18-mo period. The "time to recovery" question was administered along with a battery of renal disease-specific questionnaires and the Generic Medical Outcomes Survey 36 Item-Short Form (SF-36) plus the global Health Utilities Index. Missing data rates, reliability over time, construct validity, and sensitivity to change were assessed from the "time to recovery" responses by standard methods. The question was administered on a total of 314 occasions and answered successfully on 313. The test-retest correlation over 3-mo intervals was highly significant (r ؍ 0.962, P ؍ 0.000; n ؍ 100). Convergent construct validity was established by significant correlations between time to recovery and fatigue (r ؍ 0.38, P ؍ 0.000; n ؍ 313), dialysis stress (r ؍ 0.348, P ؍ 0.000), disease stress (r ؍ 0.374, P ؍ 0.000), SF-36 subscales especially vitality (r ؍ ؊0.356 P ؍ 0.000), and the Health Utilities Index (r ؍ ؊0.232, P ؍ 0.000). These scales captured mainly physical or physiologic domains. Divergent construct validity was established by lack of correlations between "time to recovery" and a number of subscales that captured mainly emotional or psychosocial domains, e.g., SF-36 subscale for "role emotional" (r ؍ ؊0.102, NS) and dialysis stressors such as access problems (r ؍ ؊0.015, NS) or equipment malfunction (r ؍ 0.032, NS). Test sensitivity was established when the conventionally dialyzed group showed no significant difference in time to recovery between baseline and other time periods, whereas the daily/nocturnal group had a significant reduction between baseline (while on conventional dialysis) and the result at each other time period (minimum P ؍ 0.05). There also was a significant difference between the control and experimental groups over time (ANOVA P ؍ 0.000). The response to the question, "How long does it take you to recover from a dialysis session?" is interpreted easily, is easy to which to respond, shows stability over time by test-retest, shows both convergent and divergent validity, and is sensitive to change. As such, it should be considered as a standard question in HD-related studies in which a health-related quality-of-life outcome is examined.
Is Quality of Life of Hemodialysis Patients Affected by Fatigue?
https://www.ijhsr.org/IJHSR\_Vol.7\_Issue.9\_Sep2017/IJHSR\_Abstract.023.html, 2017
Background: Patients undergoing hemodialysis are characterized by high levels of fatigue and low levels of quality of life. Patient's personal characteristics play, also, an important role. Aim: To explore the relationship between fatigue, quality of life and the demographic characteristics of patients. Method: The sample of the study consisted of 149 patients undergoing hemodialysis in public and private Hemodialysis Units. The tools used were the Missoula-VITAS Quality of Life Index-15 (MVQOLI-15) and the Fatigue Assessment Scale. At the same time, some questions about the demographic profile of patients were posed. Results: The results of the study did not show particularly high levels of fatigue, as the mean score of total fatigue was 25.97 (± 6.105). Fatigue is not related to gender, age and years of treatment of patients, but it is related to years of diagnosis, educational level, occupational status and marital status. The quality of life of patients was characterized as good. Ages is positively related to the dimension of functionality and negatively to the dimension of spirituality, while those with a low educational level, as well as males, had a low level of quality of life. Further, a negative correlation was found between fatigue and the quality of life of hemodialysis patients. Conclusions: The findings of this research contradict the results of previous research, which means that other factors may have a positive effect on patients, such as the interpersonal relationships, while the factors of income and environment should also be explored.
Background: Fatigue is a common symptom referred by many patients undergoing hemodialysis. Fatigue is associated with poor health-related quality of life (HRQoL) and is an important predictor for survival of hemodialysis patients. Aim: To assess the levels of fatigue and demographic factors affecting it among patients with End Stage Renal Disease undergoing hemodialysis. Methods: This quantitative study was carried out in two Dialysis Units of Hospitals in Athens Region. Between January 2015 and June 2015, 129 hemodialysis patients completed the Greek Version of the Fatigue Assessment Scale (FAS). Demographic data of patients was recorded. For the statistical analysis IBM SPSS Statistics version 20 was used. Results: The mean FAS score was 24.99. 49 patients (38.0%) were non fatigued, 61 patients (47.3%) were fatigued, and 19 patients (13.7%) were extremely fatigued. Higher levels of fatigue were reported among hemodialysis patients residing in urban areas, in those with low educational level and unemployed. Conclusion: The findings of this study can be used in the assessment of fatigue and early dentification of high-risk patients (especially of the unemployed, those who occupy with domestic works, those with low educational level and of urban citizens). Use of this knowledge by hemodialysis nurses may lead to a better understanding of the factors of fatigue in ESRD, which in turn may lead to a more effective treatment.