Factors influencing fatigue among patients undergoing hemodialysis: a multi-center cross-sectional study

ABSTRACT

Fatigue has been reported to be the most common symptom experienced by patients receiving hemodialysis (HD) therapy. Fatigue can lead to a reduction in their ability to engage in both routine and self-care activities, which can negatively affect their self-confidence and quality of life. This study aimed to determine the level of fatigue and the factors that affecting its level among patients receiving uHD. Methods: A cross-sectional design was utilized to explore the level of fatigue among patients receiving maintenance HD using the Mul-tidimensional Assessment of Fatigue (MAF) scale. Data were collected from four dialysis centers in two Saudi Arabia cities, Hail and Al-Qassim, between January 2022 and October 2022. Results: The questionnaire was completed by 236 patients. Older patients, male patients, and retired pa-tients reported significantly higher levels of fatigue (p < 0.001). In contrast, marital status, educational level, and financial status did not significantly affect the level of fatigue among patients (p = 0.193, 0.285, and 0.126, respectively). Patients who had seven or more dependents reported more fatigue than those who had lower levels of fatigue or who did not have dependents (p = 0.004). In addition, patients who had a regular exercise regimen reported significantly lower fatigue than those who did not have an exercise regimen (p = 0.011). Multiple linear regression demonstrated that employment status (student), comorbidity condition (one chronic disease), dialysis duration, satisfaction with dialysis time, and dialysis time were found to affect the fatigue scores (R2 = 0.302, p ˂ 0.001). Conclusion: The findings of this study gives a broader understanding of factors influencing fatigue among patients with HD that will help to develop strategies of more focused interventions to reduce fatigue among patients with HD.

KEYWORDS:

• Fatigue
• hemodialysis
• factors
• influencing
• fatigue
• Saudi Arabia

Abbreviations

CKD, Chronic Kidney Disease; HD, Hemodialysis; MAF, Multidimensional Assessment of Fatigue; QOL, Quality of Life

Author contributions

‘Conceptualization, B.A.; methodology, B.A. and S.A; formal analysis, B.A., S.A., J.A., and E.P. writing – original draft preparation B.A., S.A., J.A., and E.P.; writing – review and editing, B.A., S.A., A.A., N.M., A.K.A, M.A., S.O.A, A.A.A, F.A., J.A., and E.P.; supervision, B.A.; project administration, B.A.; funding acquisition, B.A. All authors have read and agreed to the published version of the manuscript.’

Data availability statement

The data presented in this study are available on request from the corresponding author.

Disclosure statement

No potential conflict of interest was reported by the authors.

Institutional Review Board Statement

Ethical approvals were obtained from the research ethics committees at the University of Hail number, Institutional Review Board committee at Hail health clusters, and General directorate of health affairs in Al-Qassim city (Approval Nos. (H-2021-206), (H-08-L-074), and (607-44-2091), respectively).

Informed Consent Statement

Informed consent was obtained from all subjects involved in the study. Written informed consent has been obtained from the patients to publish this paper.

Additional information

Funding

This research was supported by the Scientific Research Deanship at University of Ha’il - Saudi Arabia through project number RG-21 170.