The Effects of Comfort-Based Interventions (Back Massage and Patient and Family Education) on the Level of Comfort Among Hemodialysis Patients

Abstract

Background: Providing patients with comfort is the basis of nursing care and a favorable outcome of nursing care measures. Comfort is of special importance to hemodialysis patients because they spend a large part of their lives in hemodialysis units and are constantly dealing with different physical and mental health problems. This study aimed to evaluate the effects of comfort-based interventions (back massage along with patient and family education) on the level of comfort among hemodialysis patients. Methods: As a randomized controlled trial, this study was undertaken in 2016 in the hemodialysis unit of Shahid Chamran hospital, Ferdows, Iran. A convenience sample of forty hemodialysis patients was recruited. Patients were alternately allocated to control or intervention groups based on their hemodialysis days. The hospice comfort questionnaire was completed for all participants at the beginning and at the end of the study. This questionnaire showed that the comfort needs of patients were related to muscle cramps, headache, back pain, nausea, lack of knowledge about arteriovenous fistula care, dietary and treatment regimens, itching, rest and sleep disorders, and impaired comfort. Patients in the intervention group received massage as well as patient and family education in six consecutive hemodialysis sessions, while their counterparts in the control group solely received the routine care services of the study setting. The SPSS software (v. 18.0) was used for data analysis through running the paired-and the independent-sample t tests. The significance level was set at less than 0.05. Results: The mean scores of comfort and its environmental and psychospiritual dimensions significantly increased in the intervention group (P < 0.001). Significant increases were also observed in the mean scores of comfort and its psychospiritual dimension in the control group (P < 0.05). Before the intervention, there were no significant differences between the groups respecting the mean values of comfort and its dimensions (P > 0.05). However, after the intervention, there were significant between-group differences in the mean scores of comfort and its environmental dimension as well as in the pretest-posttest mean difference for the environmental dimension of comfort.

Evaluation of the effect of nutrition-related visual education on the comfort of patients receiving hemodialysis therapy

“…Kolcaba [7] stated that when comfort was increased with nursing interventions, individuals would increase behaviors geared towards improving health as well [8][9][10]. Studies indicate that patient education is one of the most important nursing interventions to provide comfort [11][12][13][14]. Nevertheless, the growing number of patients and factors such as complex diets, fluid, and treatment regimens make it difficult to meet these patients' educational needs [12][13][14][15].…”

The Effect of Self-Management Training on Anxiety and Comfort of Burn Patients Candidate for Skin Grafting

“…On the other hand, by reducing anxiety in these patients, the medical costs of these patients reduced and the economic burden was less in the society. 21 Therefore, since burn is a danger that threatens people in different forms every day, self-management training can be used as a useful, low-cost and easy way to reduce anxiety and increase comfort in burn patients. One of the limitations of the present study was that the economic issues and the costs of treatment were concerns of the patients, which had a significant effect on patients' anxiety and could increase anxiety and the researcher could not control the patients' medical costs.…”

Factors related to impaired comfort in chronic kidney disease patients on hemodialysis

“…Considering this discussion, a clinical trial was conducted to show the effectiveness of back massage in hemodialysis patients, and showed that the mean comfort score increased significantly in the intervention group (22) . A previous study also showed the positive effects of back massage for comfort (23) .…”