Joseph Chilcot1, Rona Moss-Morris2, Micol Artom2, Larissa Harden2, Federica Picariello2, Hector Hughes3, Sarah Bates2, Iain C Macdougall3. 1. Health Psychology Section, Psychology Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK. joseph.chilcot@kcl.ac.uk. 2. Health Psychology Section, Psychology Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK. 3. Department of Renal Medicine, King's College Hospital, London, UK.
Abstract
PURPOSE: Fatigue is commonly experienced in end-stage kidney disease (ESKD) and is associated with poor outcomes. Currently, little research has examined the psychosocial correlates of fatigue severity and its impact on renal disease patients. We predicted that psychological factors (distress, cognitions and behaviours) would be associated with fatigue severity and impairment in ESKD patients even when controlling for clinical and disease factors. METHOD: One hundred seventy-four haemodialysis patients completed the Chalder Fatigue Questionnaire (fatigue severity) and the Work and Social Adjustment Scale (fatigue-related impairment) in addition to measures evaluating distress, fatigue perceptions, symptom beliefs and behaviours. Demographic and clinical data were also collected. RESULTS: Fatigue severity was not related to haemoglobin levels, serum albumin or dialysis vintage. In hierarchical regression models, demographic and clinical factors explained 20 % of the variance in fatigue (ethnicity, body mass index, exercise, log C-reactive protein and multimorbidity). Psychological distress (beta = 0.21, p < 0.01), negative beliefs about fatigue (beta = 0.10, p = 0.01) and unhelpful behaviours (all-or-nothing behaviour [beta = 0.28, p < 0.01] and avoidance [beta = 0.16, p < 0.01]) explained an additional 36.4 % of the variance. Fatigue-related impairment was associated with psychological distress, perceptions that symptoms indicate damage, avoidance behaviour and the level of fatigue severity. CONCLUSION: Patients' mood, beliefs and behaviours are associated with fatigue in dialysis patients. Psychological interventions to alter these factors may reduce fatigue severity and fatigue-related disability in ESKD patients.
PURPOSE:Fatigue is commonly experienced in end-stage kidney disease (ESKD) and is associated with poor outcomes. Currently, little research has examined the psychosocial correlates of fatigue severity and its impact on renal diseasepatients. We predicted that psychological factors (distress, cognitions and behaviours) would be associated with fatigue severity and impairment in ESKDpatients even when controlling for clinical and disease factors. METHOD: One hundred seventy-four haemodialysis patients completed the Chalder Fatigue Questionnaire (fatigue severity) and the Work and Social Adjustment Scale (fatigue-related impairment) in addition to measures evaluating distress, fatigue perceptions, symptom beliefs and behaviours. Demographic and clinical data were also collected. RESULTS:Fatigue severity was not related to haemoglobin levels, serum albumin or dialysis vintage. In hierarchical regression models, demographic and clinical factors explained 20 % of the variance in fatigue (ethnicity, body mass index, exercise, log C-reactive protein and multimorbidity). Psychological distress (beta = 0.21, p < 0.01), negative beliefs about fatigue (beta = 0.10, p = 0.01) and unhelpful behaviours (all-or-nothing behaviour [beta = 0.28, p < 0.01] and avoidance [beta = 0.16, p < 0.01]) explained an additional 36.4 % of the variance. Fatigue-related impairment was associated with psychological distress, perceptions that symptoms indicate damage, avoidance behaviour and the level of fatigue severity. CONCLUSION:Patients' mood, beliefs and behaviours are associated with fatigue in dialysis patients. Psychological interventions to alter these factors may reduce fatigue severity and fatigue-related disability in ESKD patients.
Authors: D A Trojan; D Arnold; J-P Collet; S Shapiro; A Bar-Or; A Robinson; J-P Le Cruguel; T Ducruet; S Narayanan; K Arcelin; A N Wong; M C Tartaglia; Y Lapierre; Z Caramanos; D Da Costa Journal: Mult Scler Date: 2007-04-27 Impact factor: 6.312
Authors: Khaled Abdel-Kader; Manisha Jhamb; Lee Anne Mandich; Jonathan Yabes; Robert M Keene; Scott Beach; Daniel J Buysse; Mark L Unruh Journal: BMC Nephrol Date: 2014-02-06 Impact factor: 2.388
Authors: Christine Horvat Davey; Allison R Webel; Ashwini R Sehgal; Joachim G Voss; Anne Huml Journal: Nephrol Nurs J Date: 2019 Sep-Oct Impact factor: 0.959
Authors: Federica Picariello; Rona Moss-Morris; Iain C Macdougall; Sam Norton; Maria Da Silva-Gane; Ken Farrington; Hope Clayton; Joseph Chilcot Journal: BMJ Open Date: 2018-03-08 Impact factor: 2.692
Authors: Hannah M L Young; Sushant Jeurkar; Darren R Churchward; Maurice Dungey; David J Stensel; Nicolette C Bishop; Sharlene A Greenwood; Sally J Singh; Alice C Smith; James O Burton Journal: Clin Kidney J Date: 2018-07-05
Authors: L Ebony Boulware; Patti L Ephraim; Jessica Ameling; LaPricia Lewis-Boyer; Hamid Rabb; Raquel C Greer; Deidra C Crews; Bernard G Jaar; Priscilla Auguste; Tanjala S Purnell; Julio A Lamprea-Monteleagre; Tope Olufade; Luis Gimenez; Courtney Cook; Tiffany Campbell; Ashley Woodall; Hema Ramamurthi; Cleomontina A Davenport; Kingshuk Roy Choudhury; Matthew R Weir; Donna S Hanes; Nae-Yuh Wang; Helene Vilme; Neil R Powe Journal: BMC Nephrol Date: 2018-05-03 Impact factor: 2.388