JMERC
Owner
Janbazan Medical and Engineering Research Center (JMERC) is the owner of IJWPH.
0.5
Cite Score
SJR: 0.129 / SNIP: 0.140
Volume 17, Issue 3 (2025)
Iran J War Public Health 2025, 17(3): 223-228 |
Back to browse issues page
Article Type:
Subject:
History
Received: 2025/05/1 | Accepted: 2025/07/5 | Published: 2025/07/19
Received: 2025/05/1 | Accepted: 2025/07/5 | Published: 2025/07/19
How to cite this article
Qaed A, Atiyah H. Comfort Level in Hemodialysis Patients and Its Relationship with Symptom Burden. Iran J War Public Health 2025; 17 (3) :223-228
URL: http://ijwph.ir/article-1-1621-en.html
URL: http://ijwph.ir/article-1-1621-en.html
Download citation:
BibTeX | RIS | EndNote | Medlars | ProCite | Reference Manager | RefWorks
Send citation to:
Rights and permissions
BibTeX | RIS | EndNote | Medlars | ProCite | Reference Manager | RefWorks
Send citation to:
Authors
A.R. Qaed *1, H.H. Atiyah2
1- Ministry of Health, Al-Diwaniyah Health Directorate, Al-Diwaniyah, Iraq
2- Department of Adult Nursing, College of Nursing, University of Baghdad, Baghdad, Iraq
2- Department of Adult Nursing, College of Nursing, University of Baghdad, Baghdad, Iraq
Abstract (597 Views)
Aims: Patients with renal failure face challenges that severely hinder their independence and limit various aspects of their daily lives. Therefore, this study aimed to assess the comfort level of hemodialysis patients and its relationship with symptom burden.
Instrument & Methods: This descriptive cross-sectional study using a purposive sampling method was performed on 257 dialysis patients from six hemodialysis centers. The Chronic Kidney Disease Symptom Burden Index (CKD-SBI) and the Hemodialysis Comfort Questionnaire were used to collect data from October 28, 2024, to June 7, 2025. The Spearman’s rho correlation, Mann-Whitney U-Test, and Kruskal-Wallis Test were employed to analyze data using SPSS 26.
Findings: The mean age of the patients was 38.67 years, and the majority were male and married. Most of their education levels ranged from illiteracy to university education, and more than half (55.6%) suffered from chronic diseases. All patients (100%) had a moderate comfort level, and most (75.1%) experienced moderate symptom burden. There was a significant negative relationship between symptom burden and comfort level among the patients (p=0.01).
Conclusion: There is a significant negative relationship between symptom burden and comfort level in dialysis patients.
Instrument & Methods: This descriptive cross-sectional study using a purposive sampling method was performed on 257 dialysis patients from six hemodialysis centers. The Chronic Kidney Disease Symptom Burden Index (CKD-SBI) and the Hemodialysis Comfort Questionnaire were used to collect data from October 28, 2024, to June 7, 2025. The Spearman’s rho correlation, Mann-Whitney U-Test, and Kruskal-Wallis Test were employed to analyze data using SPSS 26.
Findings: The mean age of the patients was 38.67 years, and the majority were male and married. Most of their education levels ranged from illiteracy to university education, and more than half (55.6%) suffered from chronic diseases. All patients (100%) had a moderate comfort level, and most (75.1%) experienced moderate symptom burden. There was a significant negative relationship between symptom burden and comfort level among the patients (p=0.01).
Conclusion: There is a significant negative relationship between symptom burden and comfort level in dialysis patients.
Keywords:
References
1. Bello AK, Okpechi IG, Osman MA, Cho Y, Htay H, Jha V, et al. Epidemiology of haemodialysis outcomes. Nat Rev Nephrol. 2022;18(6):378-95. [Link] [DOI:10.1038/s41581-022-00542-7]
2. GBD Chronic Kidney Disease Collaboration. Global, regional, and national burden of chronic kidney disease, 1990-2017: A systematic analysis for the Global Burden of Disease Study 2017. Lancet. 2020;395(10225):709-33. [Link] [DOI:10.1016/S0140-6736(19)32977-0]
3. Yaseen AKM, AL-Fayyadh S. Effect of social support and spiritual well-being on the quality of life of patients undergoing hemodialysis. South East Eur J Public Health. 2024;XXIV:760-77. [Link] [DOI:10.70135/seejph.vi.1332]
4. Qi S, Yang Q, Hu S, Wang Y, Yang J, Li J, et al. The benefits of virtual reality travel on symptom burden and mental health of hemodialysis patients. J Pain Symptom Manage. 2025;69(3):e247-56. [Link] [DOI:10.1016/j.jpainsymman.2024.11.018]
5. Bossola M, Mariani I, Piccinni CP, Spoliti C, Di Stasio E. Symptom burden in patients on maintenance hemodialysis: Prevalence and severity 17 years apart. J Clin Med. 2024;13(18):5529. [Link] [DOI:10.3390/jcm13185529]
6. You AS, Kalantar SS, Norris KC, Peralta RA, Narasaki Y, Fischman R, et al. Dialysis symptom index burden and symptom clusters in a prospective cohort of dialysis patients. J Nephrol. 2022;35(5):1427-36. [Link] [DOI:10.1007/s40620-022-01313-0]
7. Zhou K, Ning F, Wang W, Li X. The mediator role of resilience between psychological predictors and health-related quality of life in breast cancer survivors: A cross-sectional study. BMC Cancer. 2022;22(1):57. [Link] [DOI:10.1186/s12885-022-09177-0]
8. Özdemir Ö. Postdialysis fatigue and comfort levels of patients receiving hemodialysis treatment. BANDIRMA ONYEDI EYLÜL ÜNIVERSITESI SAĞLIK BILIM VE ARAŞTIRMALARI DERGISI. 2024;6(2):356-65. [Link] [DOI:10.46413/boneyusbad.1439000]
9. Estridge KM, Morris DL, Kolcaba K, Winkelman C. Comfort and fluid retention in adult patients receiving hemodialysis. Nephrol Nurs J. 2018;45(1):25-60. [Link]
10. Aliwy NH, Mohammed WK. Effectiveness of an education program on hemodialysis patient's toward alleviate of itching at Al-Hussein Teaching Hospital in al-Nasiriyah City. Indian J Public Health Res Dev. 2018;9(10):617. [Link] [DOI:10.5958/0976-5506.2018.01201.9]
11. Kadhum I, Mohammed W. Nutritional status of adult hemodialysis patients in Al-Najaf al-Ashraf governorate. Iraqi Natl J Nurs Spec. 2012;25(1):64-78. [Link] [DOI:10.58897/injns.v25i1.119]
12. Jawad A, Okab A. Assessment of risk factors among renal failurepatients in Baghdad teaching hospital. Iraqi Natl J Nurs Spec. 2017;30(2):63-71. [Link] [DOI:10.58897/injns.v30i2.281]
13. Aktürk Ü, Erci B, Dural G. Comparison of quality of life and comfort levels in patients with three different chronic diseases. J Samsun Health Sci. 2023;8(1):113-28. [Link] [DOI:10.47115/jshs.1120474]
14. Yanmiş S, Molllaoğlu M. Comfort level of patients undergoing hemodialysis and associated factors in Turkey: A cross-sectional study. Niger J Clin Pract. 2024;27(6):779-84. [Link] [DOI:10.4103/njcp.njcp_890_23]
15. Gülay T, Özdemir Eler Ç, Ökdem Ş, Akgün Çitak E. Examining the comfort level of hemodialysis patients. HACETTEPE ÜNIVERSITESI HEMŞIRELIK FAKÜLTESI DERGISI. 2020;7(2):122-9. [Turkish] [Link] [DOI:10.31125/hunhemsire.763155]
16. Zarurati M, Pishgooie SA, Farsi Z, Karbaschi K. The effect of music therapy on comfort level and some vital signs of patients undergoing hemodialysismodialysis. Mil Caring Sci. 2016;3(4):221-32. [Persian] [Link] [DOI:10.18869/acadpub.mcs.3.4.221]
17. Bakey SJ. Hemodialysis nurses' practices toward hand hygiene performance at Baghdad Teaching Hospitals. Indian J Public Health Res Dev. 2019;10(4):615-21. [Link] [DOI:10.5958/0976-5506.2019.00768.X]
18. Hermis AH, Abed RI. Effectiveness of self-regulation fluid program on patients with hemodialysis self-efficacy for fluid adherence in Al-Diwaniyah Teaching Hospital. Iraqi Natl J Nurs Spec. 2021;34(2):74-88. [Link] [DOI:10.58897/injns.v34i2.577]
19. Al-Jubouri MB, Jaafar SA, Abbas MK, Gazi IN, Shawwat MA, Karmoud KF, et al. Using cryotherapy, EMLA (eutectic lidocaine/prilocaine) cream, or lidocaine spray to reduce pain during arteriovenous fistula puncture: A randomized controlled trial. Hemodial Int. 2024;28(3):270-7. [Link] [DOI:10.1111/hdi.13152]
20. Al-Juboori AKK, Khudhur IAG, Faris SH. Depression among patients with renal failure undergoing haemodialysis treatment in holy Kerbala City in Iraq. Medico Leg Update. 2020;20(1):1002-7. [Link]
21. Hnynn Si PE, Gair R, Barnes T, Dunn L, Lee S, Ariss S, et al. Symptom burden according to dialysis day of the week in three times a week haemodialysis patients. PLoS One. 2022;17(9):e0274599. [Link] [DOI:10.1371/journal.pone.0274599]
22. Hameed Z, Sachit K. Spiritual coping strategies for patients with chronic renal failure. Iraqi Natl J Nurs Spec. 2018;31(2):103-16. [Link] [DOI:10.58897/injns.v31i2.311]
23. Reynolds HR, Shaw LJ, Min JK, Spertus JA, Chaitman BR, Berman DS, et al. Association of sex with severity of coronary artery disease, ischemia, and symptom burden in patients with moderate or severe ischemia: Secondary analysis of the ISCHEMIA randomized clinical trial. JAMA Cardiol. 2020;5(7):773-86. [Link] [DOI:10.1001/jamacardio.2020.0822]
24. Tan W, Aboulhosn J. The cardiovascular burden of coronavirus disease 2019 (COVID-19) with a focus on congenital heart disease. Int J Cardiol. 2020;309:70-7. [Link] [DOI:10.1016/j.ijcard.2020.03.063]
25. Tomic D, Shaw JE, Magliano DJ. The burden and risks of emerging complications of diabetes mellitus. Nat Rev Endocrinol. 2022;18(9):525-39. [Link] [DOI:10.1038/s41574-022-00690-7]
26. Dugani SB, Mielke MM, Vella A. Burden and management of type 2 diabetes in rural United States. Diabetes Metab Res Rev. 2021;37(5):e3410. [Link] [DOI:10.1002/dmrr.3410]
27. Ng MSN, Wong CL, Ho EHS, Hui YH, Miaskowski C, So WKW. Burden of living with multiple concurrent symptoms in patients with end-stage renal disease. J Clin Nurs. 2020;29(13-14):2589-601. [Link] [DOI:10.1111/jocn.15282]
28. Lu Y, Zhai S, Liu Q, Dai C, Liu S, Shang Y, et al. Correlates of symptom burden in renal dialysis patients: A systematic review and meta-analysis. Ren Fail. 2024;46(2):2382314. [Link] [DOI:10.1080/0886022X.2024.2382314]
29. Limbong EO, Pahria T, Pratiwi SH. Symptom burden's associated factors among hemodialysis patients. JURNAL KEPERAWATAN PADJADJARAN. 2020;8(3):208-20. [Link] [DOI:10.24198/jkp.v8i3.1448]
30. Song YY, Chen L, Yu WW, Wang WX, Yang DJ, Jiang XL. Correlates of symptom burden of hemodialysis patients. West J Nurs Res. 2021;43(5):459-67. [Link] [DOI:10.1177/0193945920957229]
31. Hussain AM, Lafta RK. Burden of non-communicable diseases in Iraq after the 2003 war. Saudi Med J. 2019;40(1):72-8. [Link] [DOI:10.15537/smj.2019.1.23463]
32. Almutary H, Bonner A, Douglas C. Arabic translation, adaptation and modification of the dialysis symptom index for chronic kidney disease stages four and five. BMC Nephrol. 2015;16:36. [Link] [DOI:10.1186/s12882-015-0036-2]
33. Abid MA, Mohammed TR. Hardiness shields against depression in Iraqi dialysis patients. Acad Open. 2024;9(2). [Link] [DOI:10.21070/acopen.9.2024.9281]
34. ALkhaqani A. Effectiveness of resistance exercise therapy on patients' physiological status during hemodialysis: A randomized controlled trial. Iraqi Natl J Med. 2022;4(2):177-94. [Link] [DOI:10.37319/iqnjm.4.2.3]
35. Jassem ZA, Al-Ashour IA. Health literacy among patients undergoing hemodialysis: A descriptive study. Iraqi Natl J Nurs Spec. 2023;36(2):41-8. [Link] [DOI:10.5455/rmj.20230602053431]
36. Bilgiç Ş, Pamuk Cebeci S. Relationship between stressors and comfort level in hemodialysis patients. Arch Health Sci Res. 2022;9(2):105-9. [Link] [DOI:10.54614/ArcHealthSciRes.2022.21146]
37. Borzou SR, Anosheh M, Mohammadi E, Kazemnejad A. Patients' perception of comfort facilitators during hemodialysis procedure: A qualitative study. Iran Red Crescent Med J. 2014;16(7):e19055. [Link] [DOI:10.5812/ircmj.19055]
38. Dikmen RD, Aslan H. The effects of the symptoms experienced by patients undergoing hemodialysis treatment on their comfort levels. J Clin Nephrol Ren Care. 2020;6(2):2-9. [Link] [DOI:10.23937/2572-3286.1510060]
39. Yang N, Ornstein KA, Reckrey JM. Association between symptom burden and time to hospitalization, nursing home placement, and death among the chronically ill urban homebound. J Pain Symptom Manage. 2016;52(1):73-80. [Link] [DOI:10.1016/j.jpainsymman.2016.01.006]
40. Nixon AC, Wilkinson TJ, Young HML, Taal MW, Pendleton N, Mitra S, et al. Symptom-burden in people living with frailty and chronic kidney disease. BMC Nephrol. 2020;21(1):411. [Link] [DOI:10.1186/s12882-020-02063-6]
41. Huiskes BL, Heywood JT, Dracup K. Comfort and symptom burden associated with health-related quality of life in older women with advanced heart failure and preserved systolic function. J Card Fail. 2011;17(8):S5. [Link] [DOI:10.1016/j.cardfail.2011.06.015]
42. Demir Erbaş Ş, Akman Yılmaz A, Gençer Şendur E. Comfort and quality of life of older cardiac patients: A cross-sectional study. Eur J Geriatr Gerontol. 2023;5(2):116-23. [Link] [DOI:10.4274/ejgg.galenos.2023.2022-12-3]
43. Speyer E, Tu C, Zee J, Sesso R, Lopes AA, Moutard E, et al. Symptom burden and its impact on quality of life in patients with moderate to severe CKD: The international chronic kidney disease outcomes and practice patterns study (CKDopps). Am J Kidney Dis. 2024;84(6):696-707. [Link] [DOI:10.1053/j.ajkd.2024.06.011]
44. Bossola M, Pepe G, Picca A, Calvani R, Marzetti E. Treating symptoms to improve the quality of life in patients on chronic hemodialysis. Int Urol Nephrol. 2019;51(5):885-7. [Link] [DOI:10.1007/s11255-019-02121-5]
45. Ahmady S, Rezaei M, Khatony A. Comparing effects of aromatherapy with lavender essential oil and orange essential oil on fatigue of hemodialysis patients: A randomized trial. Complement Ther Clin Pract. 2019;36:64-8. [Link] [DOI:10.1016/j.ctcp.2019.05.005]