The effect of non-compliance with diet and liquid restriction on fatigue in dialysis patients

Bayram, Ridvan; Budak, Serkan; YIldIz, Hicran

doi:10.1590/1980-220X-REEUSP-2023-0251en

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ORIGINAL ARTICLE • Rev. esc. enferm. USP 58 • 2024 • https://doi.org/10.1590/1980-220X-REEUSP-2023-0251en copy

The effect of non-compliance with diet and liquid restriction on fatigue in dialysis patients

O efeito da não aderência à dieta e restrição de líquidos sobre a fadiga em pacientes recebendo diálise

El efecto del incumplimiento de la dieta y la restricción de líquidos en la fatiga en pacientes en diálisis

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

Objective:

This study was conducted to determine the relationship between non-compliance with dietary and fluid restriction, body mass index, and the severity of fatigue in dialysis patients.

Method:

A descriptive and cross-sectional study was conducted on 42 dialysis patients. The data were collected employing a “General Information Form”, Body Mass Index, “Fatigue Severity Scale”, and “Dialysis Diet and Fluid Non-Adherence Questionnaire.”. Data were evaluated using percentages, averages, one-way ANOVA, T-tests, and Pearson correlation tests.

Results:

The average number of days when the patients did not comply with their diet was 3.69 ± 4.85, and the average number of days when they did not comply with fluid restriction was 2.71 ± 5.02. The age and marital status of the patients were found to affect the fatigue severity. It was found that the cases were associated with creatinine and calcium values and the number of days they did not comply with fluid restriction.

Conclusion:

It was determined that there was no significant relationship between non-compliance with diet and fluid restriction and the severity of fatigue. It was found that the severity of fatigue was lower in patients who complied with diet and fluid restriction, although not significantly lower than in those who did not comply.

DESCRIPTORS
Fatigue; Diet; Dialysis; Therapeutics; Diet Therapy

Variable	Mean ± SS		Significance	Variable	Mean ± SS		Significance
Age			^¥¥¥r = 0,367^* * p < 0.05 F = One-way Anova test, t = t test, r = Pearson correlation test.	Regular exercise status	Yes	21,70 ± 13,35	t = –1,177
Age			p = 0,017	Regular exercise status	No	26,88 ± 14,37	p = 0,246
Sex	Female	28,80 ± 13,62	^¥¥t = 1,815	Blood pressure (systolic)			r = 0,033
Sex	Male	21,13 ± 13,70	P = 0,077	Blood pressure (systolic)			p = 0,834
The place where the patient’s spent most of the life	City Center	27,04 ± 14,25	^¥F = 0,793	Blood pressure (diastolic)			t = 0, 013
	County	21,25 ± 12,33	p = 0,460				p = 0,933
	Village	22,00 ± 17,44
Marital status	Married	28,59 ± 11,95	^¥¥t = 2,504	Blood pressure	hypotensive	29,27 ± 11,99	F = 1,304
	Single	17,93 ± 15,29	p = 0,016		normal	25,38 ± 15,13	p = 0,283
					hypertensive	20,15 ± 13,67
Educational status	Illiterate	33,33 ± 7,81	^¥F = 1,747	Degree of obesity	Weak	20,50 ± 28,99	F = 3,461
	Literate	16,00 ± 22,62	p = 0,149		Normal	17,93 ± 13,49	p = 0,026 ^* * p < 0.05 F = One-way Anova test, t = t test, r = Pearson correlation test.
	Primary School	30,23 ± 11,76			Overweight	26,17 ± 13,17
	Secondary School	21,75 ± 16,14			Obese	35,75 ± 5,14
	High School	19,66 ± 15,25
	University	16,25 ± 10,71
Profession	Retired	25,05 ± 14,27	^¥F = 1,447	Body Mass Index			r = 0,445
	Worker	23,00 ± 14,00	P = 0,244				*p = 0,003^ * p < 0.05 F = One-way Anova test, t = t test, r = Pearson correlation test.**
	Housewife	29,42 ± 11,50
	Other	16,75 ± 16,42
Working status	No	25,57 ± 14,28	^¥¥t = 1,132	Presence of obesity	Yes	22,20 ± 14,26	t = –2,624
Working status	Yes	17,25 ± 9,74	p = 0,264	Presence of obesity	No	35,75 ± 5,14	p = 0,012 ^* * p < 0.05 F = One-way Anova test, t = t test, r = Pearson correlation test.
Economic Condition of the family	Income < Expenses	28,44 ± 14,00	^¥F = 1,445	The presence of an individual with chronic kidney failure in the family	Yes	29,25 ± 14,17	t = 0,664
	Income=Expenses	24,67 ± 14,08	p = 0,248		No	24,31 ± 14,13	p = 0,511
	Income > Expenses	10,00 ± 2,828
Smoking Status	Smoker	31,66 ± 2,30	F = 0,392	History of any an surgical operation	No	23,86 ± 13,85	t = –0,442
	Quit	24,90 ± 13,71	p = 0,678		Yes	25,80 ± 14,54	p = 0,661
	Non-Smoker	24,00 ± 14,95
Alcohol use	Drinker	29,00 ± 0,00	F = 0,052	Another chronic disease	No	30,00 ± 15,57	t = 0,566
	Quit	25,66 ± 11,01	p = 0,950		Yes	25,00 ± 14,69	p = 0,582
	Non-Drinker	24,60 ± 14,54

Variable	Mean ± SS		Significance	Variable	Mean ± SS		Significance
Age			r = 0,098	Regular exercise status	Yes	2,94 ± 4,00	t = –0,821
Age			p = 0,537	Regular exercise status	No	4,20 ± 5,37	p = 0,416
Sex	Female	3,65 ± 4,94	t = –0,051	Blood pressure (systolic)			r = 0,055
Sex	Male	3,72 ± 4,89	p = 0,960	Blood pressure (systolic)			p = 0,727
The place where the patient’s spent most of the life	City Center	3,92 ± 4,64	F = 0,075	Blood pressure (diastolic)			t = –0, 044
	County	3,25 ± 5,20	p = 0,928				p = 0, 780
	Village	3,60 ± 6,06
Marital status	Married	3,07 ± 4,37	t = –1,107	Blood pressure	hypotensive	2,90 ± 4,78	F = 0,201
	Single	4,80 ± 5,60	p = 0,275		normal	3,83 ± 5,14	p = 0,819
					hypertensive	4,15 ± 4,81
Educational status	Illiterate	1,83 ± 3,25	F = –1,954	Degree of obesity	Weak	4,00 ± 5,65	F = 0,674
	Literate	1,00 ± 1,41	p = 0,099		Normal	1,80 ± 2,67	p = 0,305
	Primary School	3,61 ± 4,89			Overweight	4,58 ± 5,72
	Secondary School	1,25 ± 2,05			Obese	5,25 ± 5,65
	High School	7,55 ± 5,57
	University	5,66 ± 7,23
Profession	Retired	4,06 ± 5,27	F = –0,275	Body Mass Index
	Worker	7,50 ± 9,19	p = 0,785			3,32 ± 4,66	t = –1,010
	Housewife	3,28 ± 4,85				5,25 ± 5,65	p = 0,319
	Other	3,00 ± 3,89
Working status	No	3,50 ± 4,78	t = –0,731	Presence of obesity	Yes		r = 0,296
Working status	Yes	5,66 ± 7,23	p = 0,469	Presence of obesity	No		p = 0,057
Economic Condition of the family	Income < Expenses	5,33 ± 5,59	F = 0,995	The presence of an individual with chronic kidney failure in the family	Yes	3,18 ± 4,77	t = –0,708
	Income = Expenses	3,41 ± 4,72	p = 0,379		No	4,25 ± 5,00	p = 0,483
	Income > Expenses	0,50 ± 0,70
Smoking Status	Smoker	1,66 ± 2,88	F = 0,636	History of any an surgical operation	No	4,25 ± 6,65	t = 0,239
	Quit	4,90 ± 6,00	p = 0,535		Yes	3,63 ± 4,74	p = 0,812
	Non-Smoker	3,42 ± 4,54
Alcohol use	Drinker	5,00 ± 0,00	F = 0,510	Another chronic disease	No	3,47 ± 4,83	t = –0,239
	Quit	1,00 ± 1,00	p = 0,605		Yes	3,84 ± 4,96	p = 0,812
	Non-Drinker	3,86 ± 5,04

Variable	Mean ± SS		Significance	Variable	Mean ± SS		Significance
Age			r = –0,207	Regular exercise status	Yes	2,70 ± 4,98	t = –0,009
Age			p = 0,188	Regular exercise status	No	2,72 ± 5,15	p = 0,993
Sex	Female	2,80 ± 5,36	t = 0,104	Blood pressure (systolic)			r = –0,121
Sex	Male	2,63 ± 4,81	p = 0,918	Blood pressure (systolic)			p = 0,444
The place where the patient’s spent most of the life	City Center	3,04 ± 5,35	F = 0,824	Blood pressure (diastolic)			t = –0,132
	County	3,16 ± 5,27	p = 0,446				p = 0,405
	Village	1,00 ± 0,00
Marital status	Married	2,55 ± 4,68	t = –0,272	Blood pressure	hypotensive	4,00 ± 5,79	F = 2,362
	Single	3,00 ± 5,74	p = 0,787		normal	0,83 ± 3,29	p = 0,108
					hypertensive	4,23 ± 5,79
Educational status	Illiterate	0,66 ± 1,63	F = 1,925	Degree of obesity	Weak	1,00 ± 0,00	F = 0,674
	Literate	1,50 ± 2,12	p = 0,118		Normal	2,53 ± 4,82	p = 0,573
	Primary School	3,30 ± 5,49			Overweight	2,23 ± 4,64
	Secondary School	0,75 ± 1,75			Obese	4,75 ± 6,67
	High School	6,44 ± 7,19
	University	1,00 ± 0,00
Profession	Retired	2,05 ± 4,58	F = –0,440	Body Mass Index			r = 0,244
	Worker	2,00 ± 2,64	p = 0,725				p = 0,119
	Housewife	4,00 ± 6,07
	Other	2,12 ± 4,91
Working status	No	2,86 ± 5,21	t = 0,608	Presence of obesity	Yes	2,23 ± 4,54	t = –1,284
Working status	Yes	1,25 ± 2,50	p = 0,547	Presence of obesity	No	4,75 ± 6,67	p = 0,207
Economic Condition of the family	Income < Expenses	4,11 ± 5,92	F = 0,661	The presence of an individual with chronic kidney failure in the family	Yes	2,63 ± 4,81	t = –0,104
	Income = Expenses	2,48 ± 4,89	p = 0,522		No	2,80 ± 5,36	p = 0,918
	Income > Expenses	1,00 ± 0,00
Smoking Status	Smoker	1,66 ± 2,88	F = 0,067	History of any an surgical operation	No	30,50 ± 7,00	t = 0,325
	Quit	2,81 ± 5,56	p = 0,935		Yes	2,63 ± 4,89	p = 0,747
	Non-Smoker	2,78 ± 5,10
Alcohol use	Drinker	5,00 ± 0,00	F = 0,272	Another chronic disease	No	5,29 ± 6,33	t = 3,001
	Quit	1,00 ± 1,00	p = 0,763		Yes	0,96 ± 2,90	*p = 0,005^ p < 0.05 F = One-way Anova test, t = t test, r = Pearson correlation test.*
	Non-Drinker	2,78 ± 5,24

		hb	hct	ert	albumin	t.kolesterol	hdl	ldl	aks	hba1c	üre	kreatinin	alt	ast	na	k	ca	wbc	ferritin
Fatigue	r	–,091	–,063	–,036	–,198	–,017	–,045	–,080	,079	,100	,079	,092	,053	,026	,108	–,124	,055	,199	,108
Fatigue	p	,568	,692	,819	,209	,917	,776	,615	,620	,530	,620	,562	,738	,869	,498	,434	,728	,207	,496
The number of days that she has not followed the diet in the last two weeks	r	,006	,133	–,025	–,147	,001	–,118	,148	,065	,213	,097	,229	–,066	–,202	,047	,136	,004	,216	,061
	p	,972	,401	,873	,353	,993	,456	,351	,682	,175	,543	,144	,680	,199	,770	,391	,982	,170	,703
The number of days that did not comply with the fluid constraint in the last two weeks	r	,033	,162	,134	–,092	–,026	–,149	,089	–,145	,116	,037	,310^* * p < 0.05 r = Pearson correlation test.	–,111	–,234	,199	,043	–,429**	,073	–,074
	p	,835	,304	,397	,563	,872	,346	,574	,358	,464	,816	0,046	,485	,135	,206	,789	0,005	,644	,641
Degree of noncompliance with diet in the last two weeks	r	,165	,226	–,005	–,265	,145	–,090	,192	,105	,099	,251	,259	–,071	–,171	,139	,008	,002	,115	,191
Degree of noncompliance with diet in the last two weeks	p	,297	,151	,973	,090	,360	,572	,224	,508	,533	,109	,098	,653	,279	,381	,961	,990	,470	,226
Degree of noncompliance with fluid restriction in the last two weeks	r	,040	,143	,162	–,024	,010	–,199	,007	–,159	,141	,205	,411**	–,122	–,187	,214	,154	–,424**	,075	–,016
	p	,802	,366	,305	,880	,950	,207	,967	,315	,372	,193	,007	,441	,236	,173	,329	,005	,635	,920

		The number of days that she has not followed the diet in the last two weeks	The number of days that did not comply with the fluid constraint in the last two weeks	Degree of noncompliance with diet in the last two weeks	Degree of noncompliance with fluid restriction in the last two weeks
Total fatigue	r	0,147	0,229	0,034	0,034
Total fatigue	P	0,352	0,144	0,830	0,830

Universidade de São Paulo, Escola de Enfermagem Av. Dr. Enéas de Carvalho Aguiar, 419 , 05403-000 São Paulo - SP/ Brasil, Tel./Fax: (55 11) 3061-7553, - São Paulo - SP - Brazil
E-mail: reeusp@usp.br

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[1] Corresponding author: Özlüce Görükle Kampüsü 16059 – Bursa, Turkey, hicran_yildiz@yahoo.com