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Energy conservation education intervention for people with end-stage kidney disease receiving haemodialysis (EVEREST): A two-arm parallel group study
Journal article   Open access   Peer reviewed

Energy conservation education intervention for people with end-stage kidney disease receiving haemodialysis (EVEREST): A two-arm parallel group study

Sita Sharma, Kimberly E. Alexander, Theresa Green, Min-Lin Wu (Winnie) and Ann Bonner
International journal of nursing studies, Vol.166, 105032
2025
PMID: 40101671
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Open Access CC BY V4.0

Abstract

Life Sciences & Biomedicine Nursing Science & Technology
Background: Fatigue is a common symptom in kidney failure and impacts on health-related quality of life. Educational interventions involving energy conservation strategies have effectively reduced fatigue in people with other chronic diseases. Objective: To evaluate the effectiveness of an energy conservation education intervention for people with kidney failure receiving haemodialysis (EVEREST). Design: A two-arm parallel group study with haemodialysis shift randomisation. Methods: Recruitment commenced in April 2022 and included 126 participants receiving haemodialysis who met the eligibility criteria. They were randomised based on haemodialysis shifts. The intervention group received a structured energy conservation education program plus usual care over 12 weeks. The control group received the usual care. The energy conservation education program consisted of three individual face-to-face educational sessions, one booster session, and a booklet. Outcomes were fatigue, other chronic kidney disease (CKD) symptoms, occupational performance, and health-related quality of life. Data were collected at baseline, week 4, week 8, and week 12. Intention-to-treat analysis was used. Results: Participants who received the energy conservation education program showed a significant reduction in fatigue severity (mean difference [MD] =-1.88, 95 % confidence intervals [CI] [-2.36 to-1.40], p < .001), fatigue interference (MD =-1.52, 95 % CI [-2.02 to-1.02], p < .001), number of fatigue days (MD =-1.12, 95 % CI [-1.60 to-0.64], p < .001), and percent of day fatigued (MD =-18.47, 95 % CI [- 23.60 to-13.34], p < .001) at week 8 compared to the control group. At week 12, medium to large effect sizes for fatigue severity (effect size [ES] = 2.37, p < .001), fatigue interference (ES = 1.68, p < .001), number of fatigue days (ES = 0.74, p < .001), and percent of day fatigued (ES = 2.10, p < .001) were observed in the intervention group compared to the control group. Similarly, significant improvements were detected in the CKD symptom (ES = 1.49, p < .001), occupational performance (ES = 1.17, p < .001), and satisfaction with the performance (ES = 1.59, p < .001) in the intervention group compared to the control group. A significant effect was seen for health-related quality of life in the intervention group [physical health (ES = 2.14, p < .001) and mental health (ES = 2.06, p < .001)] at week 12 compared to the control group. Conclusions: The energy conservation education program was successful in reducing fatigue in the haemodialysis population. This simple approach enabled individuals to improve everyday activities, reduce other CKD symptoms and improve health-related quality of life. Nurses could incorporate the energy conservation education program into routine practice in haemodialysis units.

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UN Sustainable Development Goals (SDGs)

This output has contributed to the advancement of the following goals:

#3 Good Health and Well-Being

Source: SDGs in the Output

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