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Patient-Reported Outcome Measures for Fatigue in Patients on Hemodialysis: A Systematic Review
Angela Ju1, Mark L Unruh2, Sara N Davison3
1Sydney School of Public Health, University of Sydney, Sydney, NSW, Australia; Centre for Kidney Research, The Children's Hospital at Westmead, Sydney, NSW, Australia.
Summary
Fatigue assessment in hemodialysis patients lacks standardized, validated tools. A robust measure is needed to accurately capture patient-reported fatigue and improve care for this common complication.
Area of Science:
- Nephrology
- Clinical Trials
- Patient-Reported Outcomes
Background:
- Fatigue is a common and disabling symptom for patients undergoing hemodialysis.
- Existing patient-reported outcome measures (PROMs) for fatigue in this population vary widely.
- There is a need for a validated and feasible PROM for fatigue in hemodialysis.
Purpose of the Study:
- To systematically identify and evaluate PROMs for fatigue in hemodialysis patients.
- To assess the characteristics and psychometric properties of these fatigue measures.
- To inform the selection of a robust and feasible measure for use in randomized trials.
Main Methods:
- Systematic review of studies reporting fatigue in hemodialysis patients.
- Searched MEDLINE, Embase, PsycINFO, and CINAHL databases.
- Categorized items into content and measurement dimensions; assessed general characteristics and psychometric properties.
Main Results:
- Identified 43 different fatigue measures from 123 studies.
- Many measures were developed for other populations or lacked validation in hemodialysis patients.
- The vitality subscale of the SF-36 and Chalder Fatigue Scale showed limited validation in this population.
Conclusions:
- A wide array of fatigue measures exist for hemodialysis patients, with varying content and limited validation.
- There is a critical need for a standardized, psychometrically robust measure.
- Such a measure is essential for accurate assessment and improvement of fatigue in hemodialysis.
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