Effectiveness of selected nursing interventions on Fatigue and Quality of life among Chronic Renal Failure patients undergoing Hemodialysis in a selected hospital at Madurai
Authors: Amutha Justin Jeya 
Published: June 2021

Title: Effectiveness of selected nursing interventions on fatigue and quality of life among Chronic Renal Failure Patients undergoing Hemodialysis in a selected hospital at Madurai. Background: Non communicable diseases are increasing day by day. Health is wealth is an old saying, which is realised by people who has CKD today. As their wealth is reduced by treating the disease throughout their life time, the restrictions in food and fluid impose lot of stress, affects their Quality of life. Nearly 10% of the populations were affected by CKD and millions of them die each year because they could not afford the treatment. Hemodialysis has been proved to be the effective treatment modality. It results in a marked change in the QOL, due to number of modifications and restrictions, which affect patient’s psychological and physiological wellbeing. Dialytic nurses can play a crucial role in enhancing quality of life and reducing fatigue level through exercises and teaching. Aim: The aim of the study was to evaluate the effectiveness of selected nursing interventions on fatigue and quality of life (QOL) among chronic renal failure patients undergoing hemodialysis in a selected hospital at, Madurai. Methodology: Quasi experimental non-equivalent pretest and post-test control group design was used for the study. The study was conducted in patients undergoing hemodialysis in selected hospital at Madurai. A total of 100 patients were selected using convenient sampling technique. Tools used were Piper Fatigue Scale (PFS) and SF 36 World Health Organisation BREF QOL (SF36 WHO BREF QOL) interview scale. The therapeutic nursing intervention which includes planned teaching about care of patient with haemodialysis, demonstration of dialytic exercises, dietary management, adherence to medication, follow up, teaching on sexual relationship were administered over 4 days in a week for 4 consecutive weeks. Data was analysed using descriptive and inferential statistics. Results: The therapeutic nursing interventions were effective in improving quality of life and reducing fatigue level. Pre-test with 15th day post-test fatigue scores comparison [t =23.05, P(< 0.001)] , Comparison of pre-test with 30th day post-test fatigue scores [t =41.19, P(< 0.001)], Comparison between 15th and 30th day post-test fatigue scores [t= 25.58, P(<0.001)], Comparison of pre-test with 15th day post-test level of quality of life score [t =16.32, P(<0.001)], Comparison of pre-test with 30th day post-test level of quality of life score [t=23.76; P(<0.001)], Comparison between 15th and 30th day post-test quality of life score [t = -15.19, P(<0.001)]. The problems reported by the people were, physiological problems such as anaemia, muscle cramping, difficulty sleeping, itching, fatigue, neurological disturbances, cognitive impairment, Sexual dysfunction and psychological problems such as depression, feeling of loneliness, sadness, problems with adjustment, lack of love and affection, suicidal behaviour, delirium, anxiety and panic symptoms. The post tests in experimental group, the correlation between fatigue and quality of life in post-test-1 (15th day) was r = - 0.372 and it was significant at p = 0.008. Similarly, the correlation between fatigue and quality of life in post-test - 2 (30th day) was r = -0.370 and it was significant at p=0.008. Conclusion: The problems of the people vary from person to person, study findings concluded that, selected nursing interventions are effective intervention to improved Quality of life and reduced fatigue level. There is a real need for nurses to provide physical, mental and social support to treat the health problems and to heighten their spirit.