对接受血液透析（EVEREST）的终末期肾病患者进行节能教育干预：一项两组平行研究

IF 7.5 1区医学 Q1 NURSING

International Journal of Nursing Studies Pub Date : 2025-02-24 DOI:10.1016/j.ijnurstu.2025.105032

Sita Sharma , Kimberly E. Alexander , Theresa Green , Min-Lin Wu (Winnie) , Ann Bonner

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引用次数: 0

摘要

疲劳是肾衰竭的常见症状，并影响与健康相关的生活质量。涉及节能策略的教育干预有效地减少了患有其他慢性疾病的人的疲劳。目的评价肾衰血液透析患者节能教育干预的效果。设计一项血液透析转移随机化的双臂平行组研究。方法招募于2022年4月开始，包括126名符合资格标准的接受血液透析的参与者。他们是根据血液透析班次随机分组的。干预组接受了为期12周的结构化节能教育计划和常规护理。对照组接受常规护理。节能教育计划包括三个面对面的个人教育课程，一个助推会和一本小册子。结果是疲劳、其他慢性肾脏疾病（CKD）症状、职业表现和健康相关生活质量。在基线、第4周、第8周和第12周收集数据。使用意向治疗分析。结果接受节能教育项目的参与者疲劳程度显著降低(平均差值[MD] = - 1.88, 95%可信区间[CI] [- 2.36 ~ - 1.40], p <；措施),疲劳干扰(MD = -1.52, 95% CI 2.02−−1.02,p & lt;措施),疲劳的天数(MD = -1.12, 95% CI 1.60−−0.64,p & lt;.001)，日疲劳率(MD = -18.47, 95% CI [- 23.60 ~ - 13.34], p <；.001)，第8周与对照组相比。在第12周，疲劳严重程度的中到大效应量(效应量[ES] = 2.37, p <；.001)，疲劳干扰(ES = 1.68, p <；.001)、疲劳日数(ES = 0.74, p <；.001)，白天疲劳的百分比(ES = 2.10, p <；.001)，干预组与对照组比较差异有统计学意义。同样，CKD症状也有显著改善(ES = 1.49, p <；.001)、职业绩效(ES = 1.17, p <；.001)，对工作表现的满意度(ES = 1.59, p <；.001)，干预组与对照组比较。干预组与健康相关的生活质量有显著影响[身体健康](ES = 2.14, p <；.001)和心理健康(ES = 2.06, p <；.001)]在第12周与对照组相比。结论在血液透析人群中，节能教育能有效减少疲劳。这种简单的方法使个人能够改善日常活动，减少其他CKD症状并改善与健康相关的生活质量。护士可以将节能教育项目纳入血液透析单位的日常实践。该试验已于2020年4月23日在ClinicalTrials.gov注册（试验注册号NCT04360408）。对血液透析患者进行节能教育干预可减少疲劳，改善日常活动和健康相关的生活质量。

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Energy conservation education intervention for people with end-stage kidney disease receiving haemodialysis (EVEREST): A two-arm parallel group study

Background

Fatigue is a common symptom in kidney failure and impacts on health-related quality of life. Educational interventions involving energy conservation strategies have effectively reduced fatigue in people with other chronic diseases.

Objective

To evaluate the effectiveness of an energy conservation education intervention for people with kidney failure receiving haemodialysis (EVEREST).

Design

A two-arm parallel group study with haemodialysis shift randomisation.

Methods

Recruitment commenced in April 2022 and included 126 participants receiving haemodialysis who met the eligibility criteria. They were randomised based on haemodialysis shifts. The intervention group received a structured energy conservation education program plus usual care over 12 weeks. The control group received the usual care. The energy conservation education program consisted of three individual face-to-face educational sessions, one booster session, and a booklet. Outcomes were fatigue, other chronic kidney disease (CKD) symptoms, occupational performance, and health-related quality of life. Data were collected at baseline, week 4, week 8, and week 12. Intention-to-treat analysis was used.

Results

Participants who received the energy conservation education program showed a significant reduction in fatigue severity (mean difference [MD] = − 1.88, 95 % confidence intervals [CI] [− 2.36 to − 1.40], p < .001), fatigue interference (MD = -1.52, 95 % CI [− 2.02 to − 1.02], p < .001), number of fatigue days (MD = -1.12, 95 % CI [− 1.60 to − 0.64], p < .001), and percent of day fatigued (MD = -18.47, 95 % CI [− 23.60 to − 13.34], p < .001) at week 8 compared to the control group. At week 12, medium to large effect sizes for fatigue severity (effect size [ES] = 2.37, p < .001), fatigue interference (ES = 1.68, p < .001), number of fatigue days (ES = 0.74, p < .001), and percent of day fatigued (ES = 2.10, p < .001) were observed in the intervention group compared to the control group. Similarly, significant improvements were detected in the CKD symptom (ES = 1.49, p < .001), occupational performance (ES = 1.17, p < .001), and satisfaction with the performance (ES = 1.59, p < .001) in the intervention group compared to the control group. A significant effect was seen for health-related quality of life in the intervention group [physical health (ES = 2.14, p < .001) and mental health (ES = 2.06, p < .001)] at week 12 compared to the control group.

Conclusions

The energy conservation education program was successful in reducing fatigue in the haemodialysis population. This simple approach enabled individuals to improve everyday activities, reduce other CKD symptoms and improve health-related quality of life. Nurses could incorporate the energy conservation education program into routine practice in haemodialysis units.

Registration

The trial was registered in ClinicalTrials.gov (Trial registration ID NCT04360408) on April 23, 2020.

Tweetable abstract

Educational intervention about energy conservation for those on haemodialysis reduced fatigue and improved daily activities and health-related quality of life.

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来源期刊

International Journal of Nursing Studies 医学-护理

CiteScore

15.00

自引率

2.50%

发文量

181

审稿时长

21 days

期刊介绍： The International Journal of Nursing Studies (IJNS) is a highly respected journal that has been publishing original peer-reviewed articles since 1963. It provides a forum for original research and scholarship about health care delivery, organisation, management, workforce, policy, and research methods relevant to nursing, midwifery, and other health related professions. The journal aims to support evidence informed policy and practice by publishing research, systematic and other scholarly reviews, critical discussion, and commentary of the highest standard. The IJNS is indexed in major databases including PubMed, Medline, Thomson Reuters - Science Citation Index, Scopus, Thomson Reuters - Social Science Citation Index, CINAHL, and the BNI (British Nursing Index).