Effect of Exercise Program on Fatigue and Depression among Geriatric Patients Undergoing Hemodialysis

 
 
 
  • Abstract
  • Keywords
  • References
  • PDF
  • Abstract


    Background: Fatigue is one of the foremost common complications faced the hemodialysis elderly patients. Fatigue not only impact the daily lives and activities of patients but it conjointly influences their quality of life, which can afterwards result in magnified depression, tiny social interactions and increase dependency on others.

    Aim: Determine the effect of exercise program on fatigue and depression among geriatric patients undergoing hemodialysis.

    Design: Randomized controlled trial (pretest post-test) design was used.

    Setting: The study was carried out in the dialysis units of Mansoura University Hospital and New Mansoura General Hospital.

    Subjects: A purposive sample of 62 geriatric patients undergoing hemodialysis was selected and randomly allocated into two equal groups, study group (n = 31) and control group (n =31).

    Tools: Three tools were used; Structured interview questionnaire sheet, Multidimensional Fatigue Inventory Scale and Geriatric Depression Scale Short Form.

    Results: The mean age of the study and control groups was 63.45±4.49 and 64.7±5.25 respectively. A high statistically significant change in fatigue and depression score (pre and post 2 months) between the study and the control groups was observed (P=0.000). Moreover, a statistically significant relation was observed between fatigue and age of the hemodialysis geriatric patients after implementation of the exercise program (P= 0.002).

    Conclusion: Implementation of the exercise program proved to be effective in improving the level of fatigue and depression among geriatric patients undergoing hemodialysis in the study group.

    Recommendation: Encourage geriatric patients undergoing hemodialysis to perform regularly range of motion and relaxation exercises in order to alleviate fatigue and overcome depression.

     

     


  • Keywords


    Depression; Exercise; Fatigue; Geriatric Patients; Hemodialysis.

  • References


      [1] Huang Y., Cai X., Zhang J., Mai W., Wang S., Hu Y., Ren H., & Xu D. (2014). Prehypertension and Incidence of ESRD: A Systematic Review and Meta-analysis. American Journal of Kidney Disease, 63(1),76-83. https://doi.org/10.1053/j.ajkd.2013.07.024.

      [2] Lewis, S. L., Dirksen, S. R., Heitkemper, M. M., Bucher, L., & Camera, I. (2015). Medical-Surgical Nursing-E-Book: Assessment and Management of Clinical Problems, Single Volume. 8th ed. United States of America: Elsevier Health Sciences; 1170-4.

      [3] Wold, G. H. (2012). Basic Geriatric Nursing. 5th ed., St. louis, Mosby, Inc. affiliated to Elsevier Inc., 56.

      [4] Verberne, W. R., Geers, A. T., Jellema, W. T., Vincent, H. H., van Delden, J. J., & Bos, W. J. W. (2016). Comparative survival among older adults with advanced kidney disease managed conservatively versus with dialysis. Clinical Journal of the American Society of Nephrology, 11(4), 633-640. https://doi.org/10.2215/CJN.07510715.

      [5] Ahmed, A., Allam, M., Habil, E., Metwally, A., Ibrahiem, N., Radwan, M., El Gaafary, M., Afifi, A., Gadallah, M. (2010). Development of practice guidelines for hemodialysis in Egypt. Indian Journal of Nephrology, 20(4), 193. Retrieved from http://www.ncbi.nlm.nih.gov. https://doi.org/10.4103/0971-4065.73450.

      [6] Barsoum, R. S. (2013). Burden of chronic kidney disease: North Africa. Kidney International Supplements, 3(2), 164-166. https://doi.org/10.1038/kisup.2013.5.

      [7] Tordoir, J. H. M., Bode, A. S., & Van Loon, M. M. (2015). Preferred strategy for hemodialysis access creation in geriatric patients. European Journal of Vascular and Endovascular Surgery, 49(6), 738-743. https://doi.org/10.1016/j.ejvs.2015.02.006.

      [8] Swidler, M. A. (2009). Chapter 37: Dialysis Decisions in the Elderly Patient with Advanced CKD and the Role of Nondialytic Therapy. Retrieved from https://www.semanticscholar.org

      [9] Amini, E., Goudarzi, I., Masoudi, R., Ahmadi, A., & Momeni, A. (2016). Effect of progressive muscle relaxation and aerobic exercise on anxiety, sleep quality, and fatigue in patients with chronic renal failure undergoing hemodialysis. International Journal of Pharmaceutical and Clinical Research, 8(12), 1634-9. Retrieved from https://www.scopus.com/record/display.uri?eid=2-s2.0-85018211435&origin=inward&txGid=f92b804cdff579deb6b69138d6d2aeae

      [10] Artom, M., Moss-Morris, R., Caskey, F., & Chilcot, J. (2014). Fatigue in advanced kidney disease. Kidney International, 86(3), 497-505. https://doi.org/10.1038/ki.2014.86.

      [11] Picariello, F., Moss-Morris, R., McDougall, I. C., & Chilcot, A. J. (2016). The role of psychological factors in fatigue among end-stage kidney disease patients: a critical review. Clinical Kidney Journal, 10(1), 79-88. https://doi.org/10.1093/ckj/sfw113.

      [12] Mauk, K. L. (2014). Gerontological nursing: Competencies for care. 3rd. ed., Jones & Bartlett Publishers, 529-31.

      [13] Robnett, R. H., & Chop, W. C. (2015). Gerontology for the health care professional. 3rd ed., USA; Jones & Bartlett Publishers, 124-5.

      [14] Watnick, S., Kirwin, P., Mahnensmith, R., & Concato, J. (2003). The prevalence and treatment of depression among patients starting dialysis. American Journal of Kidney Diseases, 41(1), 105-110. https://doi.org/10.1053/ajkd.2003.50029.

      [15] Song, Y. Y., Hu, R. J., Diao, Y. S., Chen, L., & Jiang, X. L. (2018). Effects of exercise training on restless legs syndrome, depression, sleep quality, and fatigue among hemodialysis patients: A systematic review and meta-analysis. Journal of Pain and Symptom Management, 55(4), 1184-95. https://doi.org/10.1016/j.jpainsymman.2017.12.472.

      [16] White, Y. & Grenyer, B. F. S. (2006). Do we encourage health or illness? A survey of exercise rehabilitation practices for patients in Australian renal units. Renal Society of Australasia Journal, 2 (1), 5-15. Retrieved from https://ro.uow.edu.au/hbspapers/1571/

      [17] Cho, H., & Sohng, K. Y. (2014). The effect of a virtual reality exercise program on physical fitness, body composition, and fatigue in hemodialysis patients. Journal of Physical Therapy Science, 26(10), 1661-5. http://creativecommons.org/licenses/by-nc-nd/3.0/. https://doi.org/10.1589/jpts.26.1661.

      [18] Bulckaen, M., Capitanini, A., Lange, S., Caciula, A., Giuntoli, F., & Cupisti, A. (2011). Implementation of exercise training programs in a hemodialysis unit: effects on physical performance. Journal of Nephrology, 24(6), 790. https://doi.org/10.5301/JN.2011.6386.

      [19] Castner, D. (2011): Management of patients on hemodialysis before, during, and after hospitalization: challenges and suggestions for improvements. Nephrology Nursing Journal, 38(4), 319-320. Retrieved from https://www.therenalnetwork.org.

      [20] Tao, X., Chow, S. K. Y., & Wong, F. K. Y. (2015). A nurse-led case management program on home exercise training for hemodialysis patients: A randomized controlled trial. International Journal of Nursing Studies, 52(6), 1029-41. https://doi.org/10.1016/j.ijnurstu.2015.03.013.

      [21] Kontos, P., Alibhai, S. M., Miller, K. L., Brooks, D., Colobong, R., Parsons, T., & Naglie, G. (2017). A prospective 2-site parallel intervention trial of a research-based film to increase exercise amongst older hemodialysis patients. BMC Nephrology, 18(1), 37. https://doi.org/10.1186/s12882-017-0454-4.

      [22] Maniam, R., Subramanian, P., Singh, S. K. S., Lim, S. K., Chinna, K., & Rosli, R. (2014). Preliminary study of an exercise programme for reducing fatigue and improving sleep among long-term hemodialysis patients. Singapore Medical Journal, 55(9), 476. https://doi.org/10.11622/smedj.2014119.

      [23] Soliman, H. (2015). Effect of intradialytic exercise on fatigue, electrolytes level and blood pressure in hemodialysis patients: A randomized controlled trial. Journal of Nursing Education & Practice, 5(11), 16-28. https://doi.org/10.5430/jnep.v5n11p16.

      [24] Hassanpour-Dehkordi, A., & Jalali, A. (2016). Effect of progressive muscle relaxation on the fatigue and quality of life among Iranian aging persons. Acta Medica Iranica, 54(7), 430-436. Retrieved from http://acta.tums.ac.ir/index.php/acta/article/view/5009.

      [25] Smets, E. M. A., Garssen, B., Bonke, B. D., & De Haes, J. C. J. M. (1995). The Multidimensional Fatigue Inventory (MFI) psychometric qualities of an instrument to assess fatigue. Journal of Psychosomatic Research, 39(3), 315-325. https://doi.org/10.1016/0022-3999(94)00125-O.

      [26] Sheikh, J. I., & Yesavage, J. A. (1986). Geriatric Depression Scale (GDS): Recent evidence and development of a shorter version. Clinical Gerontologist: The Journal of Aging and Mental Health, 5(1-2), 165-173. https://doi.org/10.1300/J018v05n01_09.

      [27] El Elhuseiny, S. (2013). Effect of Self Care Interventions on the Quality of Life of Older Adults with Heart Failure. Published Doctorate Thesis, University of Alexandria, Faculty of Nursing. Retrieved from http://library.mans.edu.eg/eulc_v5/Libraries/.

      [28] Cruz, M. C., Andrade, C., Urrutia, M., Draibe, S., Nogueira-Martins, L. A., & Sesso, R. D. C. C. (2011). Quality of life in patients with chronic kidney disease. Clinics, 66(6), 991-995. https://doi.org/10.1590/S1807-59322011000600012.

      [29] Motedayen, Z., Nehrir, B., Tayebi, A., Ebadi, A., & Einollahi, B. (2014). The effect of the physical and mental exercises during hemodialysis on fatigue: a controlled clinical trial. Nephro-Urology Monthly, 6(4). https://doi.org/10.5812/numonthly.14686.

      [30] EL Shemy, M., Elkazeh, E., ELkually, R. (2016). Efficacy of Exercise Program in Intra Hemodialysis On patients 'Quality of Life. IOSR Journal of Nursing and Health Science, 5(1), 17-30.

      [31] Abd-Rabouh, M., Abd Elhameed, S., Shebl, A. (2017). Relationship Between Fatigue and Functional Status of the Elderly Patients on Hemodialysis. Mansoura Nursing Journal, 4(2), 83-96. Retrieved from http://library.mans.edu.eg/eulc_v5/Libraries/.

      [32] Mahmoud, M., Hassan, N., Abd Elhameed, S., Shebl, A. (2018). Relationship Between Pruritus and Quality of Life of Elderly Patients Undergoing Hemodialysis. IOSR Journal of Nursing and Health Science, 7(3):73-82.

      [33] Yong, D. S. P., Kwok, A. O. L., Wong, D. M. L., Suen, M. H. P., Chen, W. T., & Tse, D. M. W. (2009). Symptom burden and quality of life in end-stage renal disease: a study of 179 patients on dialysis and palliative care. Palliative Medicine, 23(2), 111-119. https://doi.org/10.1177/0269216308101099.

      [34] Gordon, P., Doyle, J., Johansen, K. (2011): Postdialysis fatigue is associated with sedentary behavior. Clinical Nephrology; 75(5): 426-433. PMid:21543022.

      [35] Horigan, A. E., Schneider, S. M., Docherty, S., & Barroso, J. (2013). The experience and self-management of fatigue in hemodialysis patients. Nephrology Nursing Journal: Journal of The American Nephrology Nurses' Association, 40(2), 113. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3703392/.

      [36] Chang, Y., Cheng, S.Y., Lin, M., Gau, F.Y., Chao, Y.C. (2010). The effectiveness of intradialytic leg ergometry exercise for improving sedentary life style and fatigue among patients with chronic kidney disease: a randomized clinical trial. International Journal of Nursing Studies, 47(11), 1383-8. https://doi.org/10.1016/j.ijnurstu.2010.05.002.

      [37] Turkmen, K., Erdur, F. M., Guney, I., Gaipov, A., Turgut, F., Altintepe, L., Saglam M., Tonbul H., & Abdel-Rahman, E. M. (2012). Sleep quality, depression, and quality of life in elderly hemodialysis patients. International Journal of Nephrology and Renovascular Disease, 5, 135. https://doi.org/10.2147/IJNRD.S36493.

      [38] Yaghmayi, F., Khalfi, E., Khost, N., & Alavi, A. (2005). The relationship between self-concept dimensions of health status in patients treated with hemodialysis in medical science hospital in 2004. Pajoohandeh Journal, 1(6), 9-15.

      [39] Finkelstein, F. O., Wuerth, D., Troidle, L. K., & Finkelstein, S. H. (2008). Depression and end-stage renal disease: a therapeutic challenge. Kidney international, 74(7), 843-845. https://doi.org/10.1038/ki.2008.222.

      [40] Reid, K.J., Baron, K.G., Lu, B., Naylor, E., Wolfe, L., Zee, PC. (2010). Aerobic exercise improves self-reported sleep and quality of life in older adults with insomnia. Sleep Medicine, 11(9), 934-40. https://doi.org/10.1016/j.sleep.2010.04.014.

      [41] Akin, S., Mendi, B., Ozturk, B., Cinper, C., & Durna, Z. (2014). Assessment of relationship between self‐care and fatigue and loneliness in haemodialysis patients. Journal of Clinical Nursing, 23(5-6), 856-864. https://doi.org/10.1111/jocn.12248.

      [42] Karadag, E., Kilic, S.P., Metin, O. (2013). Relationship between fatigue and social support in hemodialysis patients. Nursing & Health Sciences, 15(2), 164-171. Retrieved from https://www.ncbi.nlm.nih.gov. https://doi.org/10.1111/nhs.12008.

      [43] Bai, Y. L., Lai, L. Y., Lee, B. O., Chang, Y. Y., & Chiou, C. P. (2015). The impact of depression on fatigue in patients with haemodialysis: a correlational study. Journal of Clinical Nursing, 24(13-14), 2014-22. https://doi.org/10.1111/jocn.12804.


 

View

Download

Article ID: 29316
 
DOI: 10.14419/ijans.v8i2.29316




Copyright © 2012-2015 Science Publishing Corporation Inc. All rights reserved.