Abstract
Background and Purpose: Fatigue control in hemodialysis (HD) patients requires a multidisciplinary approach. This study aimed to comprehensively review the available research literature regarding the nonpharmacological interventions used for reducing fatigue among Iranian HD patients. Methods: In this systematic review, an extensive search of the literature was conducted on PubMed, Web of Science, and Scopus databases, using the keywords related to the purpose. Also, the Persian equivalent of these keywords was searched in Iranian databases, such as Iranmedex and Scientific Information Database (SID) from the inception to June 16, 2020. Results: Of 2,761 articles, 25 studies were included in the review. Among a total of 1,748 Iranian HD patients with a mean age of 54.17 (SD = 12.27) years, 61.38% were male. Interventions such as educational-based programs (n = 5), nutrition-based programs (n = 2), massage therapy (n = 3), exercise-based programs (n = 4), relaxation technique (n = 3), combination of relaxation technique and inhalation aromatherapy (n = 1), energy therapy (reflexology and acupressure) (n = 3), and mind-guided imagery (n = 1) were effective in reducing fatigue in Iranian HD patients. Discussion/Conclusion: These simple, low-cost, and practical interventions can be used for the reduction of fatigue among HD patients by nurses. However, future well-designed studies are recommended to confirm the efficacy of these and other potentially effective interventions for reducing fatigue in HD patients.
References
1.
Berns
JS
. Training nephrology fellows in temporary hemodialysis catheter placement and kidney biopsies is needed and should be required
. Clin J Am Soc Nephrol
. 2018
Jul
;13
(7
):1099
–101
.
[PubMed]
1555-905X2.
Amini
E
, Goudarzi
I
, Masoudi
R
, Ahmadi
A
, Momeni
A
. Effect of progressive muscle relaxation and aerobic exercise on anxiety, sleep quality, and fatigue in patients with chronic renal failure undergoing hemodialysis
. Int J Pharm Clin Res.
2016
Dec
;8
(12
):1634
–9
.3.
Raja
SM
, Seyoum
Y
. Intradialytic complications among patients on twice-weekly maintenance hemodialysis: an experience from a hemodialysis center in Eritrea
. BMC Nephrol
. 2020
May
;21
(1
):163
.
[PubMed]
1471-23694.
Picariello
F
, Norton
S
, Moss-Morris
R
, Macdougall
IC
, Chilcot
J
. Fatigue in prevalent haemodialysis patients predicts all-cause mortality and kidney transplantation
. Ann Behav Med
. 2019
May
;53
(6
):501
–14
.
[PubMed]
1532-47965.
Weisbord
SD
, Fried
LF
, Arnold
RM
, Fine
MJ
, Levenson
DJ
, Peterson
RA
, et al. Prevalence, severity, and importance of physical and emotional symptoms in chronic hemodialysis patients
. J Am Soc Nephrol
. 2005
Aug
;16
(8
):2487
–94
.
[PubMed]
1046-66736.
Jhamb
M
, Weisbord
SD
, Steel
JL
, Unruh
M
. Fatigue in patients receiving maintenance dialysis: a review of definitions, measures, and contributing factors
. Am J Kidney Dis
. 2008
Aug
;52
(2
):353
–65
.
[PubMed]
1523-68387.
Unal
KS
, Balci Akpinar
R
. The effect of foot reflexology and back massage on hemodialysis patients’ fatigue and sleep quality
. Complement Ther Clin Pract
. 2016
Aug
;24
:139
–44
.
[PubMed]
1873-69478.
Song
JH
. Complications of hemodialysis.
The Essentials of Clinical Dialysis. Springer; 2018
Aug.
p. 105-26. .9.
Rehman
IU
, Lai
PS
, Lim
SK
, Lee
LH
, Khan
TM
. Sleep disturbance among Malaysian patients with end-stage renal disease with pruritus
. BMC Nephrol
. 2019
Mar
;20
(1
):102
.
[PubMed]
1471-236910.
McCann
K
, Boore
JR
. Fatigue in persons with renal failure who require maintenance haemodialysis
. J Adv Nurs
. 2000
Nov
;32
(5
):1132
–42
.
[PubMed]
0309-240211.
Williams
AG
, Crane
PB
, Kring
D
. Fatigue in African American women on hemodialysis
. Nephrol Nurs J
. 2007
Nov-Dec
;34
(6
):610
–7
.
[PubMed]
1526-744X12.
O’Sullivan
D
, McCarthy
G
. Exploring the symptom of fatigue in patients with end stage renal disease
. Nephrol Nurs J
. 2009
Jan-Feb
;36
(1
):37
–9
.
[PubMed]
1526-744X13.
Song
YY
, Hu
RJ
, Diao
YS
, Chen
L
, Jiang
XL
. Effects of exercise training on restless legs syndrome, depression, sleep quality, and fatigue among hemodialysis patients: a systematic review and meta-analysis
. J Pain Symptom Manage
. 2018
Apr
;55
(4
):1184
–95
.
[PubMed]
1873-651314.
Heiwe
S
, Jacobson
SH
. Exercise training for adults with chronic kidney disease
. Cochrane Database Syst Rev
. 2011
Oct
;(10
):CD003236
.
[PubMed]
1469-493X15.
Feyzi
H
, Khaledi
PB
, Hadadian
F
, Rezaei
M
, Ahmadi
M
. Investigating the effects of Benson’s relaxation technique on quality of life among patients receiving hemodialysis
. Iran J Crit Care Nurs.
2015
;8
(1
):13
–20
.16.
Bagheri-Nesami
M
, Shorofi
SA
, Nikkhah
A
, Espahbodi
F
, Ghaderi Koolaee
FS
. The effects of aromatherapy with lavender essential oil on fatigue levels in haemodialysis patients: A randomized clinical trial
. Complement Ther Clin Pract
. 2016
Feb
;22
:33
–7
.
[PubMed]
1873-694717.
Muz
G
, Taşcı
S
. Effect of aromatherapy via inhalation on the sleep quality and fatigue level in people undergoing hemodialysis
. Appl Nurs Res
. 2017
Oct
;37
:28
–35
.
[PubMed]
1532-820118.
Butcher
HK
, Bulechek
GM
, Dochterman
JMM
, Wagner
CM
. Nursing Interventions classification (NIC)-E-Book. Elsevier Health Sciences; 2018
.19.
Hassanzadeh
M
, Kiani
F
, Bouya
S
, Zarei
M
. Comparing the effects of relaxation technique and inhalation aromatherapy on fatigue in patients undergoing hemodialysis
. Complement Ther Clin Pract
. 2018
May
;31
:210
–4
.
[PubMed]
1873-694720.
Xu
XM
, Liu
Y
, Jia
SY
, Dong
MX
, Cao
D
, Wei
YD
. Complementary and alternative therapies for restless legs syndrome: an evidence-based systematic review
. Sleep Med Rev
. 2018
Apr
;38
:158
–67
.
[PubMed]
1532-295521.
Ahmady
S
, Rezaei
M
, Khatony
A
. Comparing effects of aromatherapy with lavender essential oil and orange essential oil on fatigue of hemodialysis patients: A randomized trial
. Complement Ther Clin Pract
. 2019
Aug
;36
:64
–8
.
[PubMed]
1873-694722.
Habibzadeh
H
, Dalavan
OW
, Alilu
L
, Wardle
J
, Khalkhali
H
, Nozad
A
. Effects of Foot Massage on Severity of Fatigue and Quality of Life in Hemodialysis Patients: A Randomized Controlled Trial.
Int j community nurs midwifery. 2020
Apr
;8(2):92. .23.
Salehi
F
, Dehghan
M
, Mangolian Shahrbabaki
P
, Ebadzadeh
MR
. Effectiveness of exercise on fatigue in hemodialysis patients: a randomized controlled trial
. BMC Sports Sci Med Rehabil
. 2020
Mar
;12
(1
):19
.
[PubMed]
2052-184724.
Page
MJ
, McKenzie
JE
, Bossuyt
PM
, Boutron
I
, Hoffmann
TC
, Mulrow
CD
, et al. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews.
BMJ. 2021
;372:n71. . Moher D, Liberati A, Tetzlaff J, Altman DG, Group P. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. PLoS Med. 2009;6(7):e1000097. .25.
Moher D, Liberati A, Tetzlaff J, Altman DG; The PRISMA Group. Preferred Reporting Items for Systematic Reviews and Meta-Analyses: the PRISMA statement. PLoS Med. 2009;6(7):e1000097.
26.
Paez
A
. Gray literature: an important resource in systematic reviews
. J Evid Based Med
. 2017
Aug
;10
(3
):233
–40
.
[PubMed]
1756-539127.
John
JR
, Jani
H
, Peters
K
, Agho
K
, Tannous
WK
. The effectiveness of patient-centred medical home-based models of care versus standard primary care in chronic disease management: A systematic review and meta-analysis of randomised and non-randomised controlled trials
. Int J Environ Res Public Health
. 2020
Sep
;17
(18
):6886
.
[PubMed]
1660-460128.
Fazel Asgarpoor
A
, Amini
Z
, Zeraati
A
, Esmaeli
H
. The effect of a care plan based on the Roy Adaptation Model on level of Fatigue in hemodialysis patients
. Evidence Based Care.
2011
;1
(1
):77
–90
.29.
Hadian
J
, Aliasgharpoor
M
. Evaluating the effects of designed exercise program on mean of activity tolerance in hemodialysis patients
. Shahrekord Univ Med Sci J
. 2012
Jan
.1735-144830.
Biniyaz
V
, Tayebi
A
, Sadeghi Shermeh
M
, Ebadi
A
, Neamati
E
. The effect of supplementation with intravenous vitamin C on fatigue of hemodialysis patients
. Iran J Crit Care Nurs.
2013
Sep
;6
(3
):145
–54
.31.
Hasankhani
H
, Ghaderi
F
, Lakdizaji
S
, Nahamin
M
. The effect of the Slow-Stroke back massage on fatigue of dialyzed patients
. Inter Res J of Appli and Biol Sci.
2013
Sep
;4
(10
):3004
–8
. 32.
Sabouhi
F
, Kalani
L
, Valiani
M
, Mortazavi
M
, Bemanian
M
. Effect of acupressure on fatigue in patients on hemodialysis
. Iran J Nurs Midwifery Res
. 2013
Nov
;18
(6
):429
–34
.
[PubMed]
1735-906633.
Tayyebi
A
, Savari
S
, Nehrir
B
, Rahimi
A
, Eynollahi
B
. The effect of Vitamin B12 supplemention on fatigue in hemodialysis patients
. Iran J Crit Care Nurs.
2013
;6
(1
):39
–48
.34.
Bassirimoghadam
M
, Madadkardehkordi
S
, Mohammadpour
A
. Effect of progressive muscle relaxation technique on fatigue inpatients undergoing hemodialysis
. Prev Care Nurs Midwifery J.
2014
;3
(2
):24
–32
.35.
Koushan
M
, Rakhshani
M
, Mohsenpour
M
, Heshnatffar
N.
The Effect Of benson relaxation Response on hemodialysis patients fatigue. J Sabzevar Univ Med Sci. 2014
;20(5):757_65.36.
Motedayen
Z
, Nehrir
B
, Tayebi
A
, Ebadi
A
, Einollahi
B
. The effect of the physical and mental exercises during hemodialysis on fatigue: a controlled clinical trial
. Nephrourol Mon
. 2014
Jul
;6
(4
):e14686
.
[PubMed]
2251-700637.
Balouchi
A
, Masinaeinezhad
N
, Abdallahimohammad
A
, Firouzkouhi
M
, Sepehri
Z
. Comparison of effects of orange and lavender extract on fatigue in hemodialysis patients
. Pharm Lett
. 2016
;8
(8
):50
–4
.0975-507138.
Farhad
L
, Brazparandjani
S
, Latifi
SM
, Chahkhoei
M
, Khalili
A
, Paymard
A
, et al. The effect of collaborative care model on the fatigue in patients undergoing maintenance hemodialysis: A randomized clinical trial
. Qom Univ Med Sci J.
2016
Nov
;10
(8
):71
–9
.39.
Roshanravan
M
, Jouybari
L
, Bahrami Taghanaki
H
, Vakili
M
, Sanagoo
A
, Amini
Z
. Effect of foot reflexology on fatigue in patients undergoing hemodialysis: A sham-controlled randomized trial
. J Mazandaran Univ Med Sci
. 2016
Jun
;26
(137
):32
–41
.1735-926040.
Beizaee
Y
, Rejeh
N
, Heravi Karimooi
M
, Tadrisi
SD
, Bahrami
T
. HERAVI KM TS, Bahrami T. The Effect of Mind-guided Imagery on Decreasing Fatigue in Patients Undergoing Hemodialysis. Iran
. J Nurs Sci
. 2017
Apr
;12
(1
):16
–21
. 1735-907441.
Parvan
K
, Jabar-Zadeh
F
, Sarbakhsh
P
, Akhtari-Shojai
E
, Zarei
T
. The effect of exercise during hemodialysis on fatigue and self-efficacy in patients: a blind randomized clinical trial
. J Clin Anal Med.
2017
Jan
;8
:490
–5
. 42.
Izadpanah
A
, Hadavi
M
, Bahrami
T
. The effect of foot reflexology on severity of fatigue in haemodialysis patients
. J Sabzevar Univ Med Sci.
2018
Nov
;25
(4
):581
–90
.43.
Borzou
S
, Khavari
F.
The Effects of Sleep Hygiene Education on Fatigue and Sleep Quality in Hemodialysis Patients: A Quasi Experimental Study.
Avicenna J Nurs Midwifery care. 2019
Mar
;27(1):25-34. .44.
Momtaz
MS
, Arsalani
N
, Mohammadi
F
. The Effectiveness of Rehabilitation Program on Fatigue in Hemodialysis Patients
. Iran J Rehabil Res Nurs
; 2019
. 45.
Wosoi dalavan O, Habib zadeh H, Mostafazadeh A, Nozad I, Khalkhali HR. The Effect of Foot Massage Almond Oil On The Severity of Fatigue of hemodialysis Patients who Referred to teaching hospital in urmia-2016. The J Urmia Nurs Midwifery Fac.
2019
Agu;17(5):346-54.46.
Bastani
M
, Ghasemi
G
, Sadeghi
M
. The effects of selected exercises on pain, fatigue and physical function in Patients with Chronic kidney
. Majallah-i Pizishki (Tabriz)
. 2020
Apr-May
;42
(1
):24
–32
. 1608-567147.
Farragher
JF
, Thomas
C
, Ravani
P
, Manns
B
, Elliott
MJ
, Hemmelgarn
BR
. Protocol for a pilot randomised controlled trial of an educational programme for adults on chronic haemodialysis with fatigue (Fatigue-HD)
. BMJ Open
. 2019
Jul
;9
(7
):e030333
.
[PubMed]
2044-605548.
Farragher
JF
, Polatajko
HJ
, McEwen
S
, Jassal
SV
. A proof-of-concept investigation of an energy management education program to improve fatigue and life participation in adults on chronic dialysis
. Can J Kidney Health Dis
. 2020
Apr
;7
(7
):2054358120916297
.
[PubMed]
2054-358149.
Mohamed
S
. The effectiveness of an educational intervention on fatigue in hemodialysis patients: a randomized controlled trial
. J Nurs Health Sci.
2014
;3
(4
):40
–50
. 50.
Fukuda
S
, Koyama
H
, Kondo
K
, Fujii
H
, Hirayama
Y
, Tabata
T
, et al. Effects of nutritional supplementation on fatigue, and autonomic and immune dysfunction in patients with end-stage renal disease: a randomized, double-blind, placebo-controlled, multicenter trial
. PLoS One
. 2015
Mar
;10
(3
):e0119578
.
[PubMed]
1932-620351.
Carr
AC
, Vissers
MC
, Cook
JS
. The effect of intravenous vitamin C on cancer- and chemotherapy-related fatigue and quality of life
. Front Oncol
. 2014
Oct
;4
:283
.
[PubMed]
2234-943X52.
Lazarus
ER
, Amirtharaj
AD
, Jacob
D
, Chandrababu
R
, Isac
C
. The effects of an olive-oil massage on hemodialysis patients suffering from fatigue at a hemodialysis unit in southern India–a randomized controlled trial. J Complement Integr Med. 2020
;1(ahead-of-print). .53.
Shady
RH
, Ali
HM
. Effect of reflexology foot message on fatigue level for patients undergoing hemodialysis
. Int J Nurs (N Y)
. 2019
;6
(1
):151
–70
. 2373-766254.
Field
T
. Massage therapy research review
. Complement Ther Clin Pract
. 2014
Nov
;20
(4
):224
–9
.
[PubMed]
1873-694755.
Barcellos
FC
, Del Vecchio
FB
, Reges
A
, Mielke
G
, Santos
IS
, Umpierre
D
, et al. Exercise in patients with hypertension and chronic kidney disease: a randomized controlled trial
. J Hum Hypertens
. 2018
Jun
;32
(6
):397
–407
.
[PubMed]
1476-552756.
Pei
G
, Tang
Y
, Tan
L
, Tan
J
, Ge
L
, Qin
W
. Aerobic exercise in adults with chronic kidney disease (CKD): a meta-analysis
. Int Urol Nephrol
. 2019
Oct
;51
(10
):1787
–95
.
[PubMed]
1573-258457.
Paneroni
M
, Vitacca
M
, Venturelli
M
, Simonelli
C
, Bertacchini
L
, Scalvini
S
, et al. The impact of exercise training on fatigue in patients with chronic obstructive pulmonary disease: a systematic review and meta-analysis
. Pulmonology
. 2020
Sep - Oct
;26
(5
):304
–13
.
[PubMed]
2531-043758.
Razazian
N
, Kazeminia
M
, Moayedi
H
, Daneshkhah
A
, Shohaimi
S
, Mohammadi
M
, et al. The impact of physical exercise on the fatigue symptoms in patients with multiple sclerosis: a systematic review and meta-analysis
. BMC Neurol
. 2020
Mar
;20
(1
):93
.
[PubMed]
1471-237759.
Jiang
M
, Ma
Y
, Yun
B
, Wang
Q
, Huang
C
, Han
L
. Exercise for fatigue in breast cancer patients: an umbrella review of systematic reviews
. Int J Nurs Sci
. 2020
Mar
;7
(2
):248
–54
.
[PubMed]
2352-013260.
Quezada
SM
, Briscoe
J
, Cross
RK
. Complementary and Alternative Medicine
. Inflamm Bowel Dis
. 2016
Jun
;22
(6
):1523
–30
.
[PubMed]
1536-484461.
Bouya
S
, Ahmadidarehsima
S
, Badakhsh
M
, Balouchi
A
, Koochakzai
M
. Effect of aromatherapy interventions on hemodialysis complications: A systematic review
. Complement Ther Clin Pract
. 2018
Aug
;32
:130
–8
.
[PubMed]
1873-694762.
Karadag
E
, Samancioglu Baglama
S
. The Effect of Aromatherapy on Fatigue and Anxiety in Patients Undergoing Hemodialysis Treatment: A Randomized Controlled Study
. Holist Nurs Pract
. 2019
Jul/Aug
;33
(4
):222
–9
.
[PubMed]
1550-513863.
Kaplan Serin
E
, Ovayolu
N
, Ovayolu
Ö
. The effect of progressive relaxation exercises on pain, fatigue, and quality of life in dialysis patients
. Holist Nurs Pract
. 2020
Mar/Apr
;34
(2
):121
–8
.
[PubMed]
1550-513864.
Seyedi Chegeni
P
, Gholami
M
, Azargoon
A
, Hossein Pour
AH
, Birjandi
M
, Norollahi
H
. The effect of progressive muscle relaxation on the management of fatigue and quality of sleep in patients with chronic obstructive pulmonary disease: A randomized controlled clinical trial
. Complement Ther Clin Pract
. 2018
May
;31
:64
–70
.
[PubMed]
1873-694765.
Dayapoğlu
N
, Tan
M
. Evaluation of the effect of progressive relaxation exercises on fatigue and sleep quality in patients with multiple sclerosis
. J Altern Complement Med
. 2012
Oct
;18
(10
):983
–7
.
[PubMed]
1557-770866.
Hassanpour-Dehkordi
A
, Jalali
A
. Effect of progressive muscle relaxation on the fatigue and quality of life among Iranian aging persons
. Acta Med Iran
. 2016
Jul
;54
(7
):430
–6
.
[PubMed]
1735-969467.
Cho
YC
, Tsay
SL
. The effect of acupressure with massage on fatigue and depression in patients with end-stage renal disease
. J Nurs Res
. 2004
Mar
;12
(1
):51
–9
.
[PubMed]
1682-314168.
Ozdemir
G
, Ovayolu
N
, Ovayolu
O
. The effect of reflexology applied on haemodialysis patients with fatigue, pain and cramps
. Int J Nurs Pract
. 2013
Jun
;19
(3
):265
–73
.
[PubMed]
1440-172X69.
Menzies
V
, Jallo
N
. Guided imagery as a treatment option for fatigue: a literature review
. J Holist Nurs
. 2011
Dec
;29
(4
):279
–86
.
[PubMed]
1552-5724© 2021 S. Karger AG, Basel
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