Hemodiyaliz Hastalarında Semptom Yönetiminde Tamamlayıcı ve İntegratif Yaklaşımlar: Sistematik Bir Derleme

Amaç: Bu sistematik derleme, tamamlayıcı ve integratif yaklaşımların hemodiyaliz hastalarının semptomlarına etkilerini değerlendirmek amacıyla yapılmıştır. Gereç ve Yöntem: Bu derleme, Cochrane Sistematik Derleme Rehberi temel alınarak yapılandırılmıştır. Konuyla ilgili tam metinler Cochrane, PubMed, ScienceDirect, Türk Medline ve ULAKBİM Tıp’ı içeren beş veri tabanı üzerinden 01.01.2010-01.08.2020 tarihleri arasında yapılan çalışmalar taranmıştır. Kriterleri karşılayan otuz bir çalışma dahil edilmiştir. Bulgular: Derleme kapsamına alınan, hemodiyaliz hastalarında yürütülen çalışma bulgularına göre, hastaların semptom yönetiminde akupunktur (n=3), aromaterapi masajı (n=4), Benson gevşeme tekniği (n=9), masaj (n=5), meditasyon (n=1), progresif gevşeme egzersizi (n=3) ve refleksoloji (n=6) gibi yaklaşımların uygulandığı görülmüştür. Çalışmaların çoğunun (n=21) İran’da yürütüldüğü, randomize kontrollü (n=27) ve yarı-deneysel (n=4) tasarıma sahip olduğu görülmüştür. Araştırmaların yorgunluk (n=15), stres, anksiyete, depresyon (n=9), uyku sorunları (n=5) ve ağrı (n=5) gibi semptomlara yoğunlaştığı belirlenmiştir. Araştırmaların çoğunda (n=30, %96,8) hemodiyaliz hastalarının semptom puanlarında anlamlı düzeyde azalma olduğu bildirilmiştir. Sonuç: Bu çalışmada tamamlayıcı ve integratif yaklaşımların etkilerini doğrulayan yeni randomize kontrollü araştırmaların yapılması ve elde edilen sonuçlar doğrultusunda bu yaklaşımların hemodiyaliz semptomlarını hafifletmede yaygınlaştırılması önerilmiştir.

Anahtar Kelimeler:

Hemodiyaliz, semptom, sistematik derleme, tamamlayıcı terapiler

Complementary and Integrative Approaches to Symptom Management in Patients Undergoing Hemodialysis: A Systematic Review

Aim: This systematic review aimed to evaluate the effects of complementary and integrative approaches on symptoms of patients undergoing hemodialysis. Material and Methods: The review was structured on the basis of the Cochrane Systematic Review Guide. Five databases, including Cochrane, PubMed, Science Direct, Turk Medline, and ULAKBIM, were searched for relevant full-text articles between 01.01.2010 and 01.08.2020. Thirty-one studies meeting the criteria were included. Results: According to the study findings included in the review; acupuncture (n=3), aromatherapy massage (n=4), Benson relaxation technique (n=9), massage (n=5), meditation (n=1), progressive relaxation exercises (n=3), and reflexology (n=6) were used in symptom management of patients undergoing hemodialysis. It was determined that most of the studies (n=21) were conducted in Iran and had a randomized controlled (n=27) and quasi-experimental design (n=4). The studies focused on symptoms including fatigue (n=15), stress, anxiety, and depression (n=9), sleep problems (n=5), and pain (n=5). Most of the studies (n=30, 96.8%) reported that a significant decrease in symptom scores of patients undergoing hemodialysis. Conclusion: This review recommends conducting new randomized controlled studies to confirm the effects of complementary and integrative approaches and expand these approaches to alleviate hemodialysis symptoms in line with the results obtained.

Keywords:

Complementary therapies, hemodialysis, symptoms, systematic review,

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