Fatigue in persons with renal failure who require maintenance haemodialysis

Fatigue is a highly prevalent symptom experienced by persons who live with chronic illness, including those with renal failure who require maintenance haemodialysis. Fatigue, however, is a non-specific and invisible symptom and is a phenomenon that is poorly understood by health care professionals. This study examined the symptom of fatigue as experienced by a group of 39 adult haemodialysis patients. The theory of unpleasant symptoms formed the conceptual framework for the study. A descriptive correlational design was utilized to examine fatigue from an inductive approach, considering relevant physiological, psychological and situational variables based on a review of the literature. Data were collected using a structured self-report questionnaire and biochemical data from retrospective monthly blood tests. The results of the study indicated that high levels of fatigue are experienced, with correspondingly low levels of vitality, in all the areas measured - general fatigue, physical fatigue, reduced motivation, reduced activity and mental fatigue, by adult haemodialysis patients. Individual variation was noted in the dimensions of fatigue predominantly expressed. Fatigue was significantly associated with the presence of symptoms such as sleep problems, poor physical health status and depression. No associations between fatigue and the biochemical and situational variables measured were noted. Further examination of the data revealed complex relationships between the physiological and psychological factors examined. Depression was significantly associated with physical health status, sleep problems, symptoms and anxiety. Correlations were also noted between symptoms and poor physical functioning, sleep problems and depression. Based on the results, a revised version of the theory of unpleasant symptoms relating to fatigue is presented.