A Systematic Review of Potentially Effective Nonpharmacological Interventions for Reducing Fatigue among Iranian Patients Who Receive Hemodialysis
Strong EvidenceIn Plain Language
Fatigue control in hemodialysis (HD) patients requires a multidisciplinary approach. This study aimed to comprehensively review the available research literature regarding the nonpharmacological interventions used for reducing fatigue among Iranian HD patients. In this systematic review, an extensive search of the literature was conducted on PubMed, Web of Science, and Scopus databases, using the keywords related to the purpose. Also, the Persian equivalent of these keywords was searched in Iranian databases, such as Iranmedex and Scientific Information Database (SID) from the inception to June 16, 2020. Of 2,761 articles, 25 studies were included in the review. Among a total of 1,748 Iranian HD patients with a mean age of 54.17 (SD = 12.27) years, 61.38% were male. Interventions such as educational-based programs (n = 5), nutrition-based programs (n = 2), massage therapy (n = 3), exercise-based programs (n = 4), relaxation technique (n = 3), combination of relaxation technique and inhalation aromatherapy (n = 1), energy therapy (reflexology and acupressure) (n = 3), and mind-guided imagery (n = 1) were effective in reducing fatigue in Iranian HD patients. These simple, low-cost, and practical interventions can be used for the reduction of fatigue among HD patients by nurses. However, future well-designed studies are recommended to confirm the efficacy of these and other potentially effective interventions for reducing fatigue in HD patients. Hintergrund und Zielsetzung: Um die im Zusammenhang mit Hämodialyse (HD) auftretende Müdigkeit zu beherrschen, ist ein interdisziplinäres Vorgehen erforderlich. Das Ziel dieser Studie ist es, einen umfassenden Überblick über die vorliegende Forschungsliteratur zu nicht-pharmakologischen Maßnahmen zur Reduktion der Müdigkeit bei iranischen HD-Patienten zu geben. Methoden: Für diese systematische Übersichtsarbeit wurde eine umfassende Literaturrecherche in den Datenbanken PubMed, W
Key Findings: what this systematic review found
- ✓A systematic review of 25 studies involving 1,748 Iranian hemodialysis patients identified multiple nonpharmacological interventions for reducing fatigue, including educational programs, nutrition-based programs, massage therapy, exercise, and relaxation techniques.
- ✓Educational-based programs were the most frequently studied intervention for fatigue reduction in hemodialysis patients, appearing in 5 of the 25 included studies.
- ✓Exercise-based programs and relaxation techniques each appeared in multiple studies (4 and 3 studies respectively) as potentially effective nonpharmacological approaches for managing fatigue in hemodialysis patients.
What This Means for You
Reflexology is one of several low-cost, non-medication options that shows promise for reducing fatigue in hemodialysis patients, though stronger individual studies on reflexology specifically would help confirm how effective it truly is.
What This Means for Practitioners
This systematic review supports reflexology as a practical, accessible intervention that nurses and complementary practitioners can confidently offer to hemodialysis patients seeking fatigue relief.
Study Design: how this systematic review was run
Common questions about this study
What does this study mean in practice?
Reflexology is one of several low-cost, non-medication options that shows promise for reducing fatigue in hemodialysis patients, though stronger individual studies on reflexology specifically would help confirm how effective it truly is.
What did this study find?
A systematic review of 25 studies involving 1,748 Iranian hemodialysis patients identified multiple nonpharmacological interventions for reducing fatigue, including educational programs, nutrition-based programs, massage therapy, exercise, and relaxation techniques. Educational-based programs were the most frequently studied intervention for fatigue reduction in hemodialysis patients, appearing in 5 of the 25 included studies. Exercise-based programs and relaxation techniques each appeared in multiple studies (4 and 3 studies respectively) as potentially effective nonpharmacological approaches for managing fatigue in hemodialysis patients.
How strong is this evidence?
This is a systematic review and we rate its evidence strong. It covers 1,748 participants. It was published in Complementary medicine research, a Q2 journal. This study is indexed here for context; it did not test reflexology itself.
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