A Comparison of Temporal Patterns of Fatigue in Patients on Hemodialysis

Abstract

This qualitative study describes the temporal patterns of fatigue found as part of a larger study designed to elicit a description of the experience and self-management of fatigue for patients on hemodialysis. Two patterns of fatigue were identified. The first pattern, continuous fatigue, was characterized by participants who experienced fatigue at all times, which was their normal, baseline feeling. Within this group, two subgroups were identified. The second pattern of fatigue, post-dialysis fatigue only, was characterized by participants who experienced fatigue only after their hemodialysis session. This study is unique because it expands our knowledge about hemodialysis and fatigue by describing the patterns that fatigue follows over time from one hemodialysis session to the next. Insight into these phenomena could help ameliorate fatigue and allow nurses to tailor interventions for patients on hemodialysis.

Figure 1. Sample Diary

Figure 2. Continuous Fatigue with a Spike after Dialysis

Note: This figure illustrates how participants have a continuous level of fatigue that spikes after dialysis and returns back to their baseline several hours after their dialysis session. Participant A had dialysis in the afternoon with a spike in fatigue in the evening. Participants B and C had dialysis in the morning with a spike in fatigue in the afternoon.

Figure 3. Continuous Fatigue with a Plateau after Dialysis

Note: This figure illustrates that those with continuous fatigue have a prolonged recovery that lasts until the next day. For participants D and E, dialysis was completed in the afternoon. For participants F, G, H and I, dialysis was in the morning.

Figure 4. Fatigue Levels over 36 Hours in Patients with Post-Dialysis Fatigue Only

Note: This figure illustrates that patients with post-dialysis fatigue only have very low levels of fatigue that become acutely worse after dialysis and they recover from this by nighttime. Participants J and N completed dialysis in the late morning. Participants K, L, and M completed dialysis in the mid to late afternoon.