The Experience and Self-Management of Fatigue in Adult Hemodialysis Patients

Fatigue is a common and debilitating symptom for adult patients with end-stage renal disease on hemodialysis and has been associated with decreased survival and quality of life. Patients on hemodialysis must find ways to manage their fatigue and mitigate its effects on their lives. Currently, there is no description of the experience of fatigue for American hemodialysis patients, nor is there any description of the ways in which they manage their fatigue. The purpose of this qualitative descriptive work was to describe the experience and self-management of fatigue as well as how fatigue changes over time from one dialysis session to the next. Several themes were identified which included: the nature of fatigue, cycles of fatigue, management of fatigue, consequences of fatigue, and correlates of fatigue. Further, hemodialysis patients experience two types of fatigue, post-dialysis fatigue, fatigue that occurs acutely after the dialysis session and resolves after sleep or rest, and constant fatigue, a persistent, underlying fatigue that patients experience at all times and worsens after the dialysis session usually requiring a prolonged period of recovery.