The Effect of Reiki Application on Pain Severity and Quality of Life in Patients Receiving Hemodialysis Treatment
Condition: Hemodialysis
MeSH terms: Pain
Study type: Interventional

Summary: 
      Purpose The purpose of this study is to determine the effect of Reiki on pain intensity and
      quality of life in patients receiving hemodialysis treatment.

      Materials and methods The research was conducted as a qualitative study using
      pretest-posttest, double-blind, randomized controlled study and semi-structured in-depth
      interview. In this study, patients receiving HD treatment in three separate private dialysis
      centers in Turkey were randomized to Reiki and sham Reiki groups. In the first three hours of
      the HD session, in the first three hours of the HD session, three sessions a week for a total
      of 12 sessions for 30 minutes (min), the first level is applied to 9 main points (crown,
      forehead, throat, heart, solar plexus, sacral and root chakras, knees, ankles and feet).
      While applying Reiki, the sham Reiki group was touched at the same points for the same period
      of time by the uninitiated practitioner. At the beginning and end of the study, Kidney
      Disease Quality of Life (KDQOLTM-36) scores, Visual Analogue Scale (VAS-Pain) before and
      after the application, and psychodynamic reactions experienced during the Reiki application
      after the application were evaluated. At the end of the research, the Reiki group's opinions
      about the Reiki experience were collected using a form consisting of semi-structured
      questions.
    

Detailed description: 
      The fifth stage of chronic kidney disease is called end-stage renal disease (ESRD) and
      hemodialysis (HD) is offered to patients as a renal replacement treatment option unless a
      successful kidney transplantation occurs at this stage. Although HD treatment is a treatment
      option that aims to reduce mortality and morbidity rates and improve the quality of life, it
      is actually a form of treatment that brings with it different problems. Patients receiving HD
      treatment experience many physical and psychological symptoms such as pain, fatigue, dyspnea,
      sleep problems, restless leg syndrome, itching, muscle cramps, nausea-vomiting, loss of
      appetite, constipation, dry skin, sexual dysfunction, anxiety, depression, and delirium.

      In addition, these symptoms bring about social and economic problems and negatively affect
      the patient's quality of life. In patients with ESRD and receiving HD treatment; The most
      common symptom is pain due to reasons such as accumulation of fluid and metabolic wastes,
      comorbid causes such as diabetes, cardiovascular and pulmonary diseases, infections, changes
      in the musculoskeletal system, HD procedure, carpal tunnel syndrome, and anxiety.

      Pharmacological and/or complementary and integrative treatment (TIT) methods are used in the
      management of pain in patients receiving hemodialysis treatment are used. In pharmacological
      treatment, analgesics with better metabolic clearance such as fentanyl and hydromorphone are
      preferred. However, patients' inability to fully express their pain, their unwillingness to
      increase the already existing medication burden, fear of addiction or side effects of the
      medications to be used, ethnic or cultural factors, healthcare professionals' inability to
      evaluate pain adequately and lack of training in pain management are among the reasons for HD
      patients. There are difficulties in pain management due to reasons such as the lack of a
      guide on pain management. For this reason, patients prefer TIT methods such as yoga,
      reflexology, music therapy, relaxation exercises, aromatherapy, acupressure, and Reiki
      instead of drug treatment.

      Reiki, one of the energy-based treatments that has attracted great attention from nurses
      among TIT methods in recent years; It provides physical, mental and emotional healing by
      balancing the disrupted energy flow. According to the results of studies conducted on
      different patient groups; Reiki's vital signs, hemoglobin and hematocrit levels, wound
      healing, digestive problems, acute and chronic pain, sleep, fatigue, anxiety, fear,
      depression, stress, relaxation, analgesic use, self-esteem, patient satisfaction, hospital
      stay, communication, life It has been determined that its quality has positive effects on the
      side effects of chemotherapy and radiotherapy. However, the results of these studies require
      careful interpretation due to the limited number of randomized controlled studies, lack of
      sham and control groups, insufficient sample sizes, differences in population characteristics
      and protocol, frequency and duration.

      While only two studies examining the effect of Reiki on pain in patients receiving HD
      treatment have been found in the literature, no studies investigating its effect on quality
      of life have been found. Reiki is a method that can be easily learned, is non-invasive, does
      not require special equipment, is cost-free, easy to apply, reduces the use of analgesics and
      has no side effects. In addition, since it increases the quality of life by reducing the
      severity of pain when applied together with standard treatment, it stands out as one of the
      different approaches that nurses, especially those who have been with the patient for a long
      time, can offer to the patient in providing pain management. Based on this point, this study
      aimed to determine the effect of first-level Reiki, which is applied for a total of 12
      sessions for 30 minutes three times a week, in the first three hours of HD, on pain intensity
      and quality of life in individuals receiving HD treatment.
    

Intervention name(s): Reiki; Sham Reiki
Intervention type(s): Other; Other
Intervention description(s): Level I Reiki was applied to 9 points and nearby areas for 30 minutes, three sessions a week, for a total of four weeks, in the first three hours of the HD treatment, by the researcher, who completed his second level training according to the Usui method, in line with the Reiki/Sham Reiki Application Protocol.; Sham Reiki was applied to 9 points and nearby areas in accordance with the Reiki/Sham Reiki Application Protocol, for a total of four weeks, three sessions per week, for 30 minutes, in the first three hours of the HD treatment, by two students who had not received Reiki training, and were given training on the application by the researcher.
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Double (Participant, Outcomes Assessor)
Primary purpose: Supportive Care
Keywords: Hemodialysis; Reiki; Pain; Quality of life; Nursing