ABSTRACT
PURPOSE: Pain is a problem for individuals undergoing hemodialysis. Renal disease, comorbidities, concurrent symptoms, and dialysis procedures pose barriers to adequate pain management. The purpose of this study was to evaluate feasibility, examine construct validity of The Patient-Reported Outcomes Measurement Information System (PROMIS) computerized adaptive testing (CAT) instruments, and explore pain benefits of Reiki sessions conducted during hemodialysis. DESIGN: A one group, repeated-measures design was used. METHOD: Fifteen participants received Reiki for 20 minutes, twice a week for 4 weeks. Pain, fatigue, and depression were evaluated using established symptom scales and PROMIS CAT instruments. FINDINGS: Participants reported general relaxation feelings with Reiki and acceptability of using a touch-screen device to respond to web-based measures. Although staff were initially reluctant to engage patients for Reiki, they reported Reiki did not interfere with workflow and thought Reiki could be integrated into the practice setting. Significant, strong correlations with established symptom scales support construct validity of PROMIS CAT instruments. There was a significant decrease in mean symptom scores after four weeks of Reiki. Effect size values suggest a range of practical significance. CONCLUSIONS: Findings suggest Reiki provides symptom relief for individuals receiving hemodialysis, and randomized clinical trials to establish Reiki's pain benefits in this population are warranted.
Subject(s)
Pain Management/standards , Renal Dialysis/adverse effects , Therapeutic Touch/methods , Adult , Depression/psychology , Depression/therapy , Fatigue/psychology , Fatigue/therapy , Female , Humans , Male , Middle Aged , Minnesota , Pain/etiology , Pain Management/methods , Pain Measurement/methods , Renal Dialysis/methods , Therapeutic Touch/standardsABSTRACT
Pain is a major problem for individuals undergoing hemodialysis and can lead to decreased quality of life when ineffectively managed. Pain is often reported as burdensome; thus, nurses must learn effective, nonpharmacological adjuncts to help care for symptomatic patients. The purpose of this review was to identify non-pharmacologic complementary therapies and evaluate their effectiveness in minimizing pain among individuals undergoing hemodialysis. Multiple complementary interventions were identified, and several reduced pain, but evidence is qualified by limitations in study methods. Complementary therapies have the potential to reduce pain among individuals undergoing hemodialysis; however, more research is needed.
Subject(s)
Complementary Therapies/methods , Pain Management/methods , Renal Dialysis , Humans , Pain , Quality of LifeABSTRACT
BACKGROUND: Cancer-related fatigue (CRF) occurs in most people with cancer undergoing chemotherapy. Physical activity (PA) is safe and effective in reducing CRF in people with cancer. â©. OBJECTIVES: This project involved the implementation and evaluation of a three-month PA program to maintain or improve CRF and quality of life.â©. METHODS: Activity trackers and resistance bands were provided to participants. Verbal instruction, printed material, activity videos, and text messages were used in this program. Participants completed a fatigue assessment; self-reported PA measure; and measure of attitudes, beliefs, and knowledge about sustaining regular PA pre- and postimplementation.â©. FINDINGS: 51 patients enrolled in the study, and 39 completed the program. Participants' fatigue did not worsen significantly during the three months, and self-reported activity levels increased, but not significantly. The activity tracker, text messages, and personal connection with nursing staff were reported to be helpful.
Subject(s)
Ambulatory Care Facilities , Fatigue/therapy , Movement , Neoplasms/complications , Adult , Aged , Fatigue/etiology , Female , Humans , Male , Middle Aged , Patient Care TeamABSTRACT
PURPOSE/OBJECTIVES: To examine the relationship between physical performance and fatigue in child and adolescent cohorts during the first three cycles of chemotherapy. DESIGN: Prospective, observational design. SETTING: Two pediatric cancer centers in the upper Midwest region of the United States. SAMPLE: 16 children and 14 adolescents newly diagnosed with cancer. METHODS: Standardized instruments were administered during the first and third cycles of chemotherapy. Instruments included physical performance tests (Timed Up and Down Stairs [TUDS] and the 6-Minute Walk Test [6MWT]) and a self-report fatigue scale. MAIN RESEARCH VARIABLES: Fatigue and physical performance. FINDINGS: In the child cohort, physical performance appeared to improve and fatigue diminished from cycle 1 to 3 of chemotherapy. When time on TUDS decreased, fatigue tended to decrease; when 6MWT distance increased, fatigue decreased. In the adolescent cohort, fatigue seemed to decrease but physical performance measures evidenced little change. Correlations between changes in the physical performance variables and fatigue were not significant. CONCLUSIONS: Fatigue may decrease early in treatment as disease symptoms resolve. Fatigue in the child cohort was related to physical performance, which is consistent with previous studies that defined fatigue in children as primarily a physical sensation. Findings in the adolescent cohort support research that defined adolescent fatigue as more complex with mental, emotional, and physical components. IMPLICATIONS FOR NURSING: Knowing how fatigue relates to physical performance in children and adolescents informs the nurse in educating patients and families about symptom management.
