1. Department of Nephrology / Institute of Nephrology, West China Hospital, Sichuan University, Chengdu 610041, China; 2. West China School of Nursing, Sichuan University, Chengdu 610041, China; 3. Department of Nephrology, First People's Hospital, Longquanyi District, Chengdu Sichuan, Chengdu 610100, China; 4. Blood Purification Center of Jianyang People's Hospital, Jianyang 611100, China
Abstract：Objective Understand the occurrence of pain in maintenance hemodialysis (maintenance hemodialysis, MHD) patients, and explore the current situation of pain and its influencing factors. Methods A total of 345 MHD patients were selected in three tertiary general hospitals in Chengdu from January 2023 to February 2023. Visual analogue scoring (Visual Analogue Scale, VAS), GAD-7 anxiety self-assessment scale, health questionnaire depression self-rating scale (PHQ-9), Frail scale for pain, anxiety, depression, weakness and questionnaire, and analyzed the influencing factors. Results VAS score of MHD patients (3.81±2.25), frailty (2.10±1.76), anxiety (4.71±4.49), and depression (6.63±5.84), and showed significant positive correlation; orderly Logistic regression analysis showed that the influencing factors of pain in MHD patients were frailty, anxiety, depression, and family ability to pay medical expenses. Conclusion High incidence of pain in MHD patients, frailty, anxiety, depression, family ability to pay for medical expenses are the influencing factors of pain in MHD patients. It is recommended that medical staff provide timely assessment of pain in MHD patients, multidisciplinary personalized intervention, and precise care to improve the quality of life of MHD patients.
[1] IAIN C M, SUNIL B, CLAIRE W, et al.Investigators and Committees. Intravenous Iron Dosing and Infection Risk in Patients on Hemodialysis: A Prespecified Secondary Analysis of the Pivotal Trial[J]. J Am Soc Nephrol, 2020, 31(5) : 1118-1127. [2] FLEISHMAN TT, DREIHER J, SHVARTZMAN P.Pain in Maintenance Hemodialysis Patients: A Multicenter Study[J]. J Pain Symptom Manage, 2018, 56(2) : 178-184. [3] DOS SANTOS PR, MENDONÇA CR, HERNANDES JC, et al. Pain in Patients With Chronic Kidney Disease Undergoing Hemodialysis: A Systematic Review[J]. Pain Manag Nurs, 2021, 22(5) : 605-615. [4] WANG J, CHEN Z.Neuromodulation for Pain Management[J]. Adv Exp Med Biol, 2019, 1101: 207-223. [5] ROY PJ, WELTMAN M, DEMBER LM, et al.Pain management in patients with chronic kidney disease and end-stage kidney disease[J]. Curr Opin Nephrol Hypertens, 2020, 29(6) : 671-680. [6] RAINA R, KRISHNAPPA V, GUPTA M.Management of pain in end-stage renal disease patients: Short review[J]. Hemodial Int, 2017, 22(3): 290-296. [7] BOYAJI S, MERKOW J, ELMAN RNM, et al.The Role of Cannabidiol (CBD) in Chronic Pain Management: An Assessment of Current Evidence[J]. Curr Pain Headache Rep, 2020, 24(2) : 4. [8] DAVISON SN.Clinical Pharmacology Considerations in Pain Management in Patients with Advanced Kidney Failure[J]. Clin J Am Soc Nephrol, 2019, 14(6) : 917-931. [9] DAVISON SN, JHANGRI GS.The impact of chronic pain on depression, sleep, and the desire to withdraw from dialysis in hemodialysis patients[J]. J Pain Symptom Manage, 2005, 30: 465-473. [10] DAVISON SN, JHANGRI GS.Impact of pain and symptom burden on the health-related quality of life of hemodialysis patients[J]. J Pain Symptom Manage, 2010, 39: 477-485. [11] DAVISON SN, JHANGRI GS, JOHNSON JA.Cross-sectional validity of a modified Edmonton symptom assessment system in dialysis patients: a simple assessment of symptom burden[J]. Kidney Int, 2006, 69: 1621-1625. [12] KIMMEL PL, EMONT SL, NEWMANN JM, et al.ESRD patient quality of life: symptoms, spiritual beliefs, psychosocial factors, and ethnicity[J]. Am J Kidney Dis, 2003, 42: 713-721. [13] LEINAU L, MURPHY TE, BRADLEY E, et al.Relationship between conditions addressed by hemodialysis guidelines and non-ESRD-specific conditions affecting quality of life[J]. Clin J Am Soc Nephrol, 2009, 4: 572-578. [14] WEISBORD SD, CARMODY SS, BRUNS FJ, et al.Symptom burden, quality of life, advance care planning and the potential value of palliative care in severely ill haemodialysis patients[J]. Nephrol Dial Transplant, 2003, 18: 1345-1352. [15] WEISBORD SD, FRIED LF, ARNOLD RM, et al.Prevalence, severity, and importance of physical and emotional symptoms in chronic hemodialysis patients[J]. J Am Soc Nephrol, 2005, 16: 2487-2494. [16] GAMONDI C, GALLI N, SCHONHOLZER C, et al.Frequency and severity of pain and symptom distress among patients with chronic kidney disease receiving dialysis[J]. Swiss Med Wkly, 2013, 143: w13750. [17] DAVISON SN, JHANGRI GS, JOHNSON JA.Longitudinal validation of a modified Edmonton symptom assessment system (ESAS) in haemodialysis patients[J]. Nephrol Dial Transplant, 2006, 21: 3189-3195. [18] DOS SANTOS, PATRÍCIA ROBERTA, MENDONÇA, et al. Pain in Patients With Chronic Kidney Disease Undergoing Hemodialysis: A Systematic Review[J]. Pain Manag Nurs, 2021, 22(5) : 605-615. [19] MASIÀ-PLANA, AFRA, JUVINYÀ-CANAL, et al.Pain, Anxiety, and Depression in Patients Undergoing Chronic Hemodialysis Treatment: A Multicentre Cohort Study[J]. Pain Manag Nurs, 2022, 23(5) : 632-639. [20] ALSHELLEH, SAMEEHA, ALHOURI, et al. Prevelance of depression and anxiety with their effect on quality of life in chronic kidney disease patients[J]. Sci Rep, 2022 , 12(1) : 17627. [21] 高梦琳, 曾英, 王雪, 等. 维持性血液透析患者衰弱影响因素分析及其与睡眠的相关性研究[J]. 华西医学, 2022, 37(02) : 242-247. [22] NITTA K, HANAFUSA N, TSUCHIYA K.Role of frailty on outcomes of dialysis patients[J]. Contrib Nephrol, 2018, 195: 102-109. [23] KALIM S, LYONS KS, NIGWEKAR SU.Opioids in Hemodialysis Patients[J]. Semin Nephrol, 2021, 41(1) : 24-32. [24] DREIHER J, FLEISHMAN TT, SHVARTZMAN P.Pain Management Evaluation in Maintenance Hemodialysis Patients[J]. Pain Med, 2021, 22(9) : 1946-1953. [25] ZOLOTOVSKAIA IA, SHATSKAIA PR, DAVYDKIN IL, et al.Postcovid-19 Asthenic Syndrome[J]. Neurosci Behav Physiol, 2022, 52(2) : 191-195. [26] 何茂芯, 袁怀红, 杨玉洁, 等. 维持性血液透析患者肌少症与衰弱的临床研究进展[J]. 华西医学, 2022, 37(11) : 1720-1725. [27] NADORT E, RIJKERS N, SCHOUTEN RW, et al.Depression, anxiety and quality of life of hemodialysis patients before and during the COVID-19 pandemic[J]. J Psychosom Res, 2022, 158: 110917. [28] PRETTO CR, WINKELMANN ER, HILDEBRANDT LM, et al.Quality of life of chronic kidney patients on hemodialysis and related factors[J]. Rev Lat Am Enfermagem, 2020, 28: e3327. [29] TURNER BJ, RODRIGUEZ N, BOBADILLA R, et al.Chronic Pain Self-Management Program for Low-Income Patients: Themes from a Qualitative Inquiry[J]. Pain Med, 2020, 21(2) : e1-e8. [30] DAS K, PINGALI MS, PAITAL B, et al . A detailed review of the outbreak of COVID-19[J]. Front Biosci (Landmark Ed) , 2021 , 26(6) : 149-170. [31] MA Y, YU H, SUN H, et al.Economic burden of maintenance hemodialysis patients' families in Nanchong and its influencing factors[J]. Ann Palliat Med, 2020 , 9(6) : 3877-3884. [32] 肖卫强, 彭毅梅, 陈俊伊, 等. 音乐疗法联合右美托咪定对LC患者炎症的影响[J]. 湖南师范大学学报 (医学版) , 2022, 19(02) : 140-143.
2024, Vol. 21 
