การจัดกระทำเพื่อเพิ่มคุณภาพชีวิตในผู้ป่วยโรคไตเรื้อรังระยะสุดท้ายที่ได้รับการฟอกเลือดด้วยเครื่องไตเทียม: การทบทวนอย่างเป็นระบบ

Abstract

End stage renal disease patients receiving hemodialysis often experience a low quality of life. Therefore, interventions to improve quality of life among end stage renal disease patients receiving hemodialysis are important. The objective of this systematic review was to summarize the effectiveness of program interventions to enhance the quality of life among end stage renal disease patients receiving hemodialysis. The systematic search strategy focused on randomized controlled trials (RCTs) and quasi-experimental, published or unpublished research studies in Thai or English, reported between 2003 and 2020. The review used a systematic review strategy of the Joanna Briggs Institute (Joanna Briggs Institute [JBI], 2017) for the guideline process. The quality of the study was evaluated using the Critical Appraisal Tool for RCTs and the Critical Appraisal Tool for Quasi- Experimental Studies (JBI, 2017). by Chiang Mai University A total of 147 full texts were screened and 54 studies met the inclusion criteria. Thirty-four studies met the study quality using the Critical Appraisal checklists, and these included 1 9 randomized controlled trial (RCTs) studies and 15 quasi-experimental studies. Fifteen studies were eligible for meta-analysis. Interventions to improve quality of life among end stage renal disease patients receiving hemodialysis included 1) exercise, 2) education, 3) psychological interventions, 4) visual imagery, 5) occupational therapy, 6) physical therapy, 7) complementary medicine, and 8) nursing interventions. Meta-analysis results show that exercise can improve quality of life in the physical health domain, with an SMD of 0.66 (95% CI 0.30-1.02, p < .0001). Resistance exercise improved quality of life in the physical domain (SMD 0.77, 95% CI 0.22-1.33, p = .006). A combination of aerobic and resistance exercise did not improve quality of life in the physical and mental health domain. In addition, moderate heterogeneity was found. Education did not improve quality of life and other interventions could not summarize because of few studies included. These systematic review results suggested that exercise improve the quality of life regarding physical health. Use of this intervention should be monitored periodically. Other interventions should be conducted to summarize their effectiveness.