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Circling around in tiredness: perspectives of patients on peritoneal dialysis
Linköping University, Department of Medical and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences.
Linköping University, Department of Social and Welfare Studies, Division of Health, Activity and Care. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Local Health Care Services in East Östergötland, Department of LAH/Linnéa.ORCID iD: 0000-0002-9606-3238
Kalmar Regional Hospital.
Linköping University, Department of Medical and Health Sciences, Nephrology. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Centre for Medicine, Department of Nephrology UHL.
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2010 (English)In: Nephrology Nursing Journal : Journal of The American Nephrology Nurses Association, ISSN 1526-744X, E-ISSN 2163-5390, Vol. 37, no 4, 407-413 p.Article in journal (Refereed) Published
Abstract [en]

The experience of tiredness linked to poor sleep in patients on peritoneal dialysis was explored using the qualitative method phenomenology. Eight women and six men in southeast Sweden were interviewed. The patients' descriptions were characterized by a circular structure "circling around in tiredness." This study illustrates the problems of tiredness and illuminates the need for healthcare professionals to assess the impact of tiredness and highlight the need for strategies to improve the patient's situation.

Place, publisher, year, edition, pages
Journal of the American Nephrology Nurses' Association , 2010. Vol. 37, no 4, 407-413 p.
National Category
Nursing
Identifiers
URN: urn:nbn:se:liu:diva-59529PubMedID: 20830948OAI: oai:DiVA.org:liu-59529DiVA: diva2:352127
Available from: 2010-09-20 Created: 2010-09-17 Last updated: 2017-12-12Bibliographically approved
In thesis
1. Sleep Problems in Patients on Peritoneal Dialysis: Prevalence, Effects on Daily Life and Evaluation of Non-Pharmacological Interventions
Open this publication in new window or tab >>Sleep Problems in Patients on Peritoneal Dialysis: Prevalence, Effects on Daily Life and Evaluation of Non-Pharmacological Interventions
2011 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Sleep problems affect a considerable number (49-86%) of patients undergoing peritoneal dialysis (PD) treatment. Insomnia i.e. difficulties to initiate and/or maintain sleep or too early wakening, combined with daytime symptoms, seems to be the dominating problem. Despite these facts there is a lack of research in PD-patients, especially studies with objective data on the sleep-wake cycle and evaluation of sleep promoting non-pharmacological  interventions.

The overall aim of this thesis was to describe sleep problems from different perspectives, and how these problems affect daily life and health in patients treated with PD at home. The aim was also to evaluate an individualised non-pharmacological intervention for improvement of sleep quality outcomes.

Four studies were conducted during eight years, starting in 2002. Patients from six hospitals in the south-east of Sweden were invited to participate. In addition, data from a reference group with Coronary Artery Disease and a population group were used for comparisons with PD-patients in one of the studies. Data was collected by self-reported questionnaires, actigraphy registrations and interviews. Sleep was evaluated in a 17-week single-case study with an intervention focusing on sleep hygiene advice.

Data from a total of 700 sleep-wake cycles was collected in the patients’ homes. The main findings clearly demonstrated that PD-patients have seriously fragmented sleep compared to the CAD- and population group, and that the PD-patients have a high prevalence of insomnia. The sleep was mainly disturbed by pruritus and Restless Legs Syndrome (RLS). Daytime impairments and a frequent napping behaviour were detected. The prevalence of fatigue was also reported to be extremely high. The patients described that an ever-present tiredness and poor sleep had consequences in their everyday life both physically, mentally, socially and existentially. The nurse-led intervention demonstrated that individual, non-pharmacological sleep interventions can improve sleep and daytime activities in PD-patients.

This thesis elucidates that deteriorated sleep with serious fragmentation leads to a variety of daytime impairments and fatigue. By adopting “renal supportive care” in clinical work a more elaborate assessment and individualised non-pharmacological treatment of sleep problems may improve sleep quality and activity in frail patients undergoing peritoneal dialysis at home.

Place, publisher, year, edition, pages
Linköping: Linköping University Electronic Press, 2011. 103 p.
Series
Linköping University Medical Dissertations, ISSN 0345-0082 ; 1233
Keyword
Fatigue, insomnia, peritoneal dialysis, renal supportive care, sleep, self-care management, sleep hygiene
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-68041 (URN)978-91-7393-207-3 (ISBN)
Public defence
2011-05-13, Berzeliussalen, Universitetssjukhuset, Campus US, Linköpings univeristet, Linköping, 09:00 (Swedish)
Opponent
Supervisors
Available from: 2011-05-06 Created: 2011-05-06 Last updated: 2013-09-03Bibliographically approved

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Yngman-Uhlin, PiaFriedrichsen, MariaFernström, AndersEdéll-Gustafsson, Ulla

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Yngman-Uhlin, PiaFriedrichsen, MariaFernström, AndersEdéll-Gustafsson, Ulla
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Nursing ScienceFaculty of Health SciencesDivision of Health, Activity and CareDepartment of LAH/LinnéaNephrologyDepartment of Nephrology UHL
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Nephrology Nursing Journal : Journal of The American Nephrology Nurses Association
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