Abstract
Amaç: Bu çalışmanın amacı hemodiyaliz hastalarının yaşadığı kaşıntıyı çok
boyutlu değerlendirmek ve kaşıntının, uyku ile anksiyete arasındaki ilişkisini
incelemektir.
Gereç ve Yöntem: Tanımlayıcı nitelikte olan bu çalışma, Ocak- Mart 2020
tarihleri arasında Akdeniz bölgesinde iki devlet hastanesinin diyaliz merkezinde
gerçekleştirildi. Çalışmaya hemodiyaliz tedavisi alan 114 hasta dahil edildi.
Çalışmanın verileri, Tanıtıcı Bilgi Formu, 5 D Kaşıntı ölçeği, Richard-Campbell
Uyku Ölçeği, Spielberg Durumluk-Sürekli Kaygı Ölçeği kullanılarak elde edildi.
Bulgular: Çalışmada hastaların yarısına yakınının ciddi ve orta derecede kaşıntı
yaşadığı belirlendi. Hastaların 5 D kaşıntı ölçeğinden toplam 12.44 ± 7.11 (orta
şiddette); sürekli kaygı ölçeğinden toplam 49.54±13,03; Richard-Campbell Uyku
Ölçeğinden toplam 50.44±27.71 puan aldıkları saptandı. Hastaların % 41.2’sinin
çok kötü uyku kalitesine sahip olduğu belirlendi. Kaşıntı ve uyku arasında orta
derecede (p=.000; r=-.679); kaşıntı ve anksiyete arasında yüksek derede (p=.000;
r=.706) korelasyonel bir ilişki bulundu. Yapılan lineer regresyonda kaşıntı hem
anksiyetenin hem de uykunun belirleyicisi olarak saptandı.
Sonuç: Bu çalışmada hemodiyaliz hastalarının yarısına yakınının orta ve şiddetli
derecede kaşıntı yaşadığı ve günlük yaşamlarının önemli derecede etkilendiği
belirlendi. Çalışmanın diğer önemli bir sonucu da kaşıntı ile uyku kalitesi ve
anksiyete arasındaki ilişkinin varlığıdır. Bu sonuçlara dayanarak hemodiyaliz
hastalarında etkin semptom yönetiminin sağlanması için kaşıntı semptomlarının
diyaliz hemşireleri tarafından çok boyutlu değerlendirilmesi önerilmektedir.
Kaşıntı semptomlarının hemodiyaliz hastalarında çok boyutlu değerlendirilmesi
ile uyku, anksiyete ve yaşam kalitesi üzerindeki etkisinin belirlenmesini
sağlayarak hastaların morbiditesini azaltacağı ve yaşam kalitesini artıracağı
öngörülmektedir.
Keywords
References
- 1. Mettang T, Kremer AE. Uremic pruritus. Kidney International. 2015;87(4):685-91.
- 2. Hashimoto T, Yosipovitch G. Itching as a systemic disease. Journal of Allergy and Clinical Immunology. 2019; 144(2): 375-80.
- 3. Khan TM, Wu DB-C, Goh B-H, Lee L-H, Alhafez AA, Sulaiman SAS. An observational longitudinal study investigating the effectiveness of 75 mg pregabalin post-hemodialysis among uremic pruritus patients. Scientific Reports. 2016; 6(1): 1-9.
- 4. Rehman IU, Munib S, Ramadas A, Khan TM. Prevalence of chronic kidney disease-associated pruritus, and association with sleep quality among hemodialysis patients in Pakistan. PloS One. 2018; 13(11): e0207758.
- 5. Sanai M, Aman S, Nadeem M, Kazmi AH. Dermatologic manifestations in patients of renal disease on hemodialysis. Journal of Pakistan Association of Dermatology. 2016; 20(3): 163-8.
- 6. Akhyani M, Ganji M-R, Samadi N, Khamesan B, Daneshpazhooh M. Pruritus in hemodialysis patients. BMC Dermatology. 2005; 5(7): 1-6.
- 7. Erturk IE, Arican O, Omurlu IK, Sut N. Effect of the pruritus on the quality of life: a preliminary study. Annals of Dermatology. 2012; 24(4): 406-12.
- 8. Rehman IU, Lai PSM, Lim SK, Lee LH, Khan TM. Sleep disturbance among Malaysian patients with end-stage renal disease with pruritus. BMC Nephrology. 2019; 20(1): 102.
- 9. Wu C-F, Hsiao Y-C, Ko P-C. The effects of nonpharmacological treatment on uremic pruritus patients: A systematic review. Advances in Nursing. 2015; 2015: 1-9.
- 10. Lin TC, Lai YH, Guo SE, Liu CF, Tsai JC, Guo HR, et al. Baby oil therapy for uremic pruritus in haemodialysis patients. Journal of Clinical Nursing. 2012; 21(1‐2): 139-48.
- 11. Rehman IU, Chohan TA, Bukhsh A, Khan TM. Impact of Pruritus on Sleep Quality of Hemodialysis Patients: A Systematic Review and Meta-Analysis. Medicina. 2019; 55(10): 699.
- 12. Shirazian S, Aina O, Park Y, Chowdhury N, Leger K, Hou L, et al. Chronic kidney disease-associated pruritus: impact on quality of life and current management challenges. International Journal of Nephrology and Renovascular Disease. 2017; 10: 11-26.
- 13. Kılıç Akça N, Taşçı S. An important problem among hemodialysis patients: uremic pruritus and Affecting Factors. Turk Nephrol Dial Transplant Journal. 2014; 23(3): 210-6.
- 14. Lopes GB, Nogueira FCP, de Souza MR, Penalva MA, de Amorim JL, Pisoni RL, et al. Assessment of the psychological burden associated with pruritus in hemodialysis patients using the kidney disease quality of life short form. Quality of Life Research. 2012; 21(4): 603-12.
- 15. Kılıç AKÇA N, Taşçı S. Kaşıntı Kontrolünde Kullanılan Nonfarmakolojik Yöntemler. TAF Preventive Medicine Bulletin. 2013; 12(3): 359-64.
- 16. Weiss M, Mettang T, Tschulena U, Passlick-Deetjen J, Weisshaar E. Prevalence of chronic itch and associated factors in hemodialysis patients – Results from a representative cross-sectional study. Acta Derm Venereol. 2015;85(7): 816- 21.
- 17. Weiss M, Mettang T, Tschulena U, Weisshaar E. Health-related quality of life in haemodialysis patients suffering from chronic itch: results from GEHIS (German Epidemiology Haemodialysis Itch Study). Quality of Life Research. 2016; 25(12): 3097-106.
- 18. Ozen N, Cinar FI, Askin D, Mut D. Uremic pruritus and associated factors in hemodialysis patients: A multi-center study. Kidney Research and Clinical Practice. 2018; 37(2): 138-47.
- 19. Akça NK. Hemodiyaliz Tedavisi Alan Hastalarda Sık Karşılaşılan Cilt Sorunları ve Hemşirelik Bakımı. Nefroloji Hemşireliği Dergisi. 2019; 14(1): 26-32.
- 20. Elmaati HMBA. Impact of Uremic Pruritus Nursing Management on Itching and Sleep Disturbance among Hemodialysis Patients. World Journal of Nursing Sciences. 2018; 4(3): 149-53.
- 21. Karadag E, Kilic SP, Karatay G, Metin O. Effect of baby oil on pruritus, sleep quality, and quality of life in hemodialysis patients: Pretest–post‐test model with control groups. Japan Journal of Nursing Science. 2014; 11(3): 180-9.
- 22. Dehghanmehr S, Mansouri A, Faghihi H, Piri F. The effect of acupressure on the anxiety of patients undergoing hemodialysis-a review. Journal of Pharmaceutical Sciences and Research. 2017; 9(12): 2580-4.
- 23. Ersoy NA, Akyar İ. Multidimensional pruritus assessment in hemodialysis patients. BMC Nephrology. 2019; 20(42): 1-7.
- 24. Daugirdas JT. Second generation logarithmic estimates of single-pool variable volume Kt/V: an analysis of error. Journal of the American Society of Nephrology. 1993; 4(5): 1205-13.
- 25. Ersoy NA, Akyar İ. Validity and reliability of 5-D itch scale on chronic renal disease patients. Acıbadem Üniversitesi Sağlık Bilimleri Dergisi. 2018; 9(4): 455-61.
- 26. Özlü ZK, Özer N. Richard-Campbell Uyku Ölçeği Geçerlilik ve Güvenilirlik Çalışması. Journal of Turkish Sleep Medicine. 2015; 2: 29-32.
- 27. Öner N. Türkiye’de kullanılan psikolojik testler. İstanbul: Boğaziçi Üniversitesi Yayınları. 1997:150-1.
- 28. Sukul N, Wang M, Bieber B, Li Y, Lopes AA, Speyer E, et al. Sp295 Pruritis ın Chronic Kidney Disease Patients: Early Results From Ckdopps. Oxford University Press; 2016.
- 29. Pisoni RL, Wikström B, Elder SJ, Akizawa T, Asano Y, Keen ML, et al. Pruritus in haemodialysis patients: International results from the Dialysis Outcomes and Practice Patterns Study (DOPPS). Nephrology Dialysis Transplantation. 2006; 21(12): 3495-505.
- 30. Weisshaar E, Apfelbacher C, Jäger G, Zimmermann E, Bruckner T, Diepgen T, et al. Pruritus as a leading symptom: clinical characteristics and quality of life in German and Ugandan patients. British Journal of Dermatology. 2006; 155(5): 957-64.
- 31. Edalat-Nejad M, Qlich-Khani M. Quality of life and sleep in hemodialysis patients. Saudi Journal of Kidney Diseases and Transplantation. 2013; 24(3): 514-8.
- 32. Mirghaed MT, Sepehrian R, Rakhshan A, Gorji H. Sleep quality in Iranian hemodialysis patients: A systematic review and meta-analysis. Iranian Journal of Nursing and Midwifery Research. 2019; 24(6): 403-9.
- 33. Brekke FB, Waldum B, Amro A, Østhus TB, Dammen T, Gudmundsdottir H, et al. Self‐perceived quality of sleep and mortality in N orwegian dialysis patients. Hemodialysis International. 2014; 18(1): 87-94.
- 34. Elder SJ, Pisoni RL, Akizawa T, Fissell R, Andreucci VE, Fukuhara S, et al. Sleep quality predicts quality of life and mortality risk in haemodialysis patients: results from the Dialysis Outcomes and Practice Patterns Study (DOPPS). Nephrology Dialysis Transplantation. 2008; 23(3): 998-1004.
- 35. Vasilopoulou C, Bourtsi E, Giaple S, Koutelekos I, Theofilou P, Polikandrioti M. The impact of anxiety and depression on the quality of life of hemodialysis patients. Global Journal of Health Science. 2016; 8(1): 45-55.
- 36. Soleymanian T, Alidadiani S, Mahdavi A. Pruritus and insomnia in hemodialysis patients; association with SF36 quality of life and clinical outcomes. Journal of Renal Injury Prevention. 2018; 7(4): 253-8.
- 37. SuSeł J, Batycka-Baran A, Reich A, SzEPIETOWSKI JC. Uraemic pruritus markedly affects the quality of life and depressive symptoms in haemodialysis patients with end-stage renal disease. Acta Dermato-Venereologica. 2014; 94(3): 276-81.
- 38. Kimata N, Fuller DS, Saito A, Akizawa T, Fukuhara S, Pisoni RL, et al. Pruritus in hemodialysis patients: Results from the J apanese D ialysis O utcomes and P ractice P atterns S tudy (JDOPPS). Hemodialysis International. 2014; 18(3): 657-67.
Abstract
Objective: The aim of this study is to evaluate the itching experienced by
hemodialysis patients in multiple dimensions and to examine the relationship
between itching and sleep and anxiety.
Method: This descriptive study was conducted in the dialysis center of two state
hospitals in the Mediterranean region between January-March 2020. 114 patients
who underwent hemodialysis session were included in the study. The data of the
study were obtained by using the Introductory Information Form, 5 D Itch scale,
Richard-Campbell Sleep Scale (R-CUS), Spielberg State-Trait Anxiety Scale.
Results: In the study, it was determined that almost half of the patients
experienced severe and moderate itching. The total mean score of the patients on
the 5D itch scale was 12.44 ± 7.11 (moderate); 49.54 ± 13.03 from the trait
anxiety scale; It was determined that they got 50.44 ± 27.71 points from the
Richard-Campbell Sleep Scale. It was determined that 41.2% of the patients had
very bad sleep. Moderate between itching and sleep (p = .000; r = -. 679);
Correlation was found between itching and anxiety at high level (p = .000; r = -.
706). In the linear regression, itching was determined as a determinant of both
anxiety and sleep.
Conclusion: In this study, it was determined that almost half of hemodialysis
patients experienced moderate and severe itching and their daily lives were
significantly affected. Another important result of the study was the relationship
between itching and sleep quality and anxiety. Based on these results, it is
recommended that the itching symptoms are evaluated multi-dimensionally by the
dialysis nurses to ensure effective symptom management in hemodialysis patients.
Multidimensional evaluation of itching symptoms in hemodialysis patients is
thought to decrease the morbidity and increase the quality of life by enabling the
determination of the effect on sleep, anxiety and quality of life.
Keywords
References
- 1. Mettang T, Kremer AE. Uremic pruritus. Kidney International. 2015;87(4):685-91.
- 2. Hashimoto T, Yosipovitch G. Itching as a systemic disease. Journal of Allergy and Clinical Immunology. 2019; 144(2): 375-80.
- 3. Khan TM, Wu DB-C, Goh B-H, Lee L-H, Alhafez AA, Sulaiman SAS. An observational longitudinal study investigating the effectiveness of 75 mg pregabalin post-hemodialysis among uremic pruritus patients. Scientific Reports. 2016; 6(1): 1-9.
- 4. Rehman IU, Munib S, Ramadas A, Khan TM. Prevalence of chronic kidney disease-associated pruritus, and association with sleep quality among hemodialysis patients in Pakistan. PloS One. 2018; 13(11): e0207758.
- 5. Sanai M, Aman S, Nadeem M, Kazmi AH. Dermatologic manifestations in patients of renal disease on hemodialysis. Journal of Pakistan Association of Dermatology. 2016; 20(3): 163-8.
- 6. Akhyani M, Ganji M-R, Samadi N, Khamesan B, Daneshpazhooh M. Pruritus in hemodialysis patients. BMC Dermatology. 2005; 5(7): 1-6.
- 7. Erturk IE, Arican O, Omurlu IK, Sut N. Effect of the pruritus on the quality of life: a preliminary study. Annals of Dermatology. 2012; 24(4): 406-12.
- 8. Rehman IU, Lai PSM, Lim SK, Lee LH, Khan TM. Sleep disturbance among Malaysian patients with end-stage renal disease with pruritus. BMC Nephrology. 2019; 20(1): 102.
- 9. Wu C-F, Hsiao Y-C, Ko P-C. The effects of nonpharmacological treatment on uremic pruritus patients: A systematic review. Advances in Nursing. 2015; 2015: 1-9.
- 10. Lin TC, Lai YH, Guo SE, Liu CF, Tsai JC, Guo HR, et al. Baby oil therapy for uremic pruritus in haemodialysis patients. Journal of Clinical Nursing. 2012; 21(1‐2): 139-48.
- 11. Rehman IU, Chohan TA, Bukhsh A, Khan TM. Impact of Pruritus on Sleep Quality of Hemodialysis Patients: A Systematic Review and Meta-Analysis. Medicina. 2019; 55(10): 699.
- 12. Shirazian S, Aina O, Park Y, Chowdhury N, Leger K, Hou L, et al. Chronic kidney disease-associated pruritus: impact on quality of life and current management challenges. International Journal of Nephrology and Renovascular Disease. 2017; 10: 11-26.
- 13. Kılıç Akça N, Taşçı S. An important problem among hemodialysis patients: uremic pruritus and Affecting Factors. Turk Nephrol Dial Transplant Journal. 2014; 23(3): 210-6.
- 14. Lopes GB, Nogueira FCP, de Souza MR, Penalva MA, de Amorim JL, Pisoni RL, et al. Assessment of the psychological burden associated with pruritus in hemodialysis patients using the kidney disease quality of life short form. Quality of Life Research. 2012; 21(4): 603-12.
- 15. Kılıç AKÇA N, Taşçı S. Kaşıntı Kontrolünde Kullanılan Nonfarmakolojik Yöntemler. TAF Preventive Medicine Bulletin. 2013; 12(3): 359-64.
- 16. Weiss M, Mettang T, Tschulena U, Passlick-Deetjen J, Weisshaar E. Prevalence of chronic itch and associated factors in hemodialysis patients – Results from a representative cross-sectional study. Acta Derm Venereol. 2015;85(7): 816- 21.
- 17. Weiss M, Mettang T, Tschulena U, Weisshaar E. Health-related quality of life in haemodialysis patients suffering from chronic itch: results from GEHIS (German Epidemiology Haemodialysis Itch Study). Quality of Life Research. 2016; 25(12): 3097-106.
- 18. Ozen N, Cinar FI, Askin D, Mut D. Uremic pruritus and associated factors in hemodialysis patients: A multi-center study. Kidney Research and Clinical Practice. 2018; 37(2): 138-47.
- 19. Akça NK. Hemodiyaliz Tedavisi Alan Hastalarda Sık Karşılaşılan Cilt Sorunları ve Hemşirelik Bakımı. Nefroloji Hemşireliği Dergisi. 2019; 14(1): 26-32.
- 20. Elmaati HMBA. Impact of Uremic Pruritus Nursing Management on Itching and Sleep Disturbance among Hemodialysis Patients. World Journal of Nursing Sciences. 2018; 4(3): 149-53.
- 21. Karadag E, Kilic SP, Karatay G, Metin O. Effect of baby oil on pruritus, sleep quality, and quality of life in hemodialysis patients: Pretest–post‐test model with control groups. Japan Journal of Nursing Science. 2014; 11(3): 180-9.
- 22. Dehghanmehr S, Mansouri A, Faghihi H, Piri F. The effect of acupressure on the anxiety of patients undergoing hemodialysis-a review. Journal of Pharmaceutical Sciences and Research. 2017; 9(12): 2580-4.
- 23. Ersoy NA, Akyar İ. Multidimensional pruritus assessment in hemodialysis patients. BMC Nephrology. 2019; 20(42): 1-7.
- 24. Daugirdas JT. Second generation logarithmic estimates of single-pool variable volume Kt/V: an analysis of error. Journal of the American Society of Nephrology. 1993; 4(5): 1205-13.
- 25. Ersoy NA, Akyar İ. Validity and reliability of 5-D itch scale on chronic renal disease patients. Acıbadem Üniversitesi Sağlık Bilimleri Dergisi. 2018; 9(4): 455-61.
- 26. Özlü ZK, Özer N. Richard-Campbell Uyku Ölçeği Geçerlilik ve Güvenilirlik Çalışması. Journal of Turkish Sleep Medicine. 2015; 2: 29-32.
- 27. Öner N. Türkiye’de kullanılan psikolojik testler. İstanbul: Boğaziçi Üniversitesi Yayınları. 1997:150-1.
- 28. Sukul N, Wang M, Bieber B, Li Y, Lopes AA, Speyer E, et al. Sp295 Pruritis ın Chronic Kidney Disease Patients: Early Results From Ckdopps. Oxford University Press; 2016.
- 29. Pisoni RL, Wikström B, Elder SJ, Akizawa T, Asano Y, Keen ML, et al. Pruritus in haemodialysis patients: International results from the Dialysis Outcomes and Practice Patterns Study (DOPPS). Nephrology Dialysis Transplantation. 2006; 21(12): 3495-505.
- 30. Weisshaar E, Apfelbacher C, Jäger G, Zimmermann E, Bruckner T, Diepgen T, et al. Pruritus as a leading symptom: clinical characteristics and quality of life in German and Ugandan patients. British Journal of Dermatology. 2006; 155(5): 957-64.
- 31. Edalat-Nejad M, Qlich-Khani M. Quality of life and sleep in hemodialysis patients. Saudi Journal of Kidney Diseases and Transplantation. 2013; 24(3): 514-8.
- 32. Mirghaed MT, Sepehrian R, Rakhshan A, Gorji H. Sleep quality in Iranian hemodialysis patients: A systematic review and meta-analysis. Iranian Journal of Nursing and Midwifery Research. 2019; 24(6): 403-9.
- 33. Brekke FB, Waldum B, Amro A, Østhus TB, Dammen T, Gudmundsdottir H, et al. Self‐perceived quality of sleep and mortality in N orwegian dialysis patients. Hemodialysis International. 2014; 18(1): 87-94.
- 34. Elder SJ, Pisoni RL, Akizawa T, Fissell R, Andreucci VE, Fukuhara S, et al. Sleep quality predicts quality of life and mortality risk in haemodialysis patients: results from the Dialysis Outcomes and Practice Patterns Study (DOPPS). Nephrology Dialysis Transplantation. 2008; 23(3): 998-1004.
- 35. Vasilopoulou C, Bourtsi E, Giaple S, Koutelekos I, Theofilou P, Polikandrioti M. The impact of anxiety and depression on the quality of life of hemodialysis patients. Global Journal of Health Science. 2016; 8(1): 45-55.
- 36. Soleymanian T, Alidadiani S, Mahdavi A. Pruritus and insomnia in hemodialysis patients; association with SF36 quality of life and clinical outcomes. Journal of Renal Injury Prevention. 2018; 7(4): 253-8.
- 37. SuSeł J, Batycka-Baran A, Reich A, SzEPIETOWSKI JC. Uraemic pruritus markedly affects the quality of life and depressive symptoms in haemodialysis patients with end-stage renal disease. Acta Dermato-Venereologica. 2014; 94(3): 276-81.
- 38. Kimata N, Fuller DS, Saito A, Akizawa T, Fukuhara S, Pisoni RL, et al. Pruritus in hemodialysis patients: Results from the J apanese D ialysis O utcomes and P ractice P atterns S tudy (JDOPPS). Hemodialysis International. 2014; 18(3): 657-67.
Details
| Primary Language | Turkish |
|---|---|
| Subjects | Nursing |
| Journal Section | Article |
| Authors | |
| Publication Date | May 31, 2020 |
| Published in Issue | Year 2020 Volume: 15 Issue: 2 |
Journal of Nephrology Nursing is licensed 
under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.