伸展運動介入血液透析患者預防不寧腿症候群再復發之實證照護

台灣地區末期腎臟疾病盛行率及發生率均為世界第一位，不寧腿症候群（restless legs syndrome, RLS）是一種感覺運動神經學障礙，血液透析患者合併RLS發生率高達6.6-70%不等，約有20%患者因RLS症狀干擾而中斷治療使得血液透析效果不佳。本個案是一位診斷末期腎臟病合併不寧腿症候群之血液透析患者，因不寧腿症候群導致透析治療受到中斷，筆者運用實證護理探討伸展運動是否可避免病人於血液透析治療過程，發生不寧腿症候群而中斷透析治療。故搜尋CINAHL, Cochrane library, Medline, PubMed等資料庫，使用關鍵字＂hemodialysis＂, ＂stretching exercises＂, ＂restless legs syndrome＂之MeSH term及同義字，搜尋2015年1月至2020年1月近五年之英文實證文獻，最後萃取出2篇與血液透析患者不寧腿症候群與伸展運動文章納入分析，並以隨機研究評讀工具查核文獻以比較研究之完整性與品質，結果發現血液透析過程最後2小時，進行30分鐘伸展運動能有效預防不寧腿症候群。且伸展運動不具侵入性且無經濟負擔，做為輔助療法個案接受度高且可獨立操作。期望藉此實證案例照護經驗，提供醫護人員依據臨床照護需求，運用實證技巧找出最佳照護方式。

關鍵字

伸展運動；血液透析；不寧腿症候群；實證照護

並列摘要

The prevalence and incidence of end-stage kidney disease in Taiwan are both top 1 around the world. Restless legs syndrome (RLS) is a sensorimotor neurological disorder, and the incidence of patients undergoing hemodialysis complicated with RLS is as high as 6.6-70%. Approximately 20% of patients discontinue treatment due to the interference of RLS, leading to poor hemodialysis effect. The case is a hemodialysis patient with end-stage kidney disease complicated with RLS who had to discontinue treatment due to RLS. The author used empirical nursing to investigate whether stretching exercise can prevent patients from discontinuing hemodialysis process. Therefore, this study searched databases, such as CINAHL, Cochrane library, Medline, and PubMed, and used the Keywords ＂hemodialysis＂, ＂stretching exercises＂, ＂restless legs syndrome＂ MeSH terms and synonyms to search empirical literature in English from January 2015 to January 2020 (in recent 5 years). Lastly, this study extracted 2 studies associated with patients undergoing hemodialysis complicated with RLS and stretching exercise for analysis. Moreover, this study used CASP to inspect literature and compare the integrity and quality of studies. The results showed that the implementation of 30-minute stretching exercise in the final 2 hours of hemodialysis effectively prevented RLS. Besides, stretching exercise is noninvasive and does not create any economic burden. Stretching exercise can be highly accepted as an adjuvant therapy and operated independently. Hopefully, the empirical nursing experience may serve as reference for medical and nursing personnel to meet the clinical care needs and apply empirical skills to find the best care method.

並列關鍵字

stretching exercise ； hemodialysis ； restless legs syndrome ； empirical nursing

參考文獻

江銘彥、呂宜樺、王嬋婷、黃志強(2013)．透析患者的不寧腿症候群．腎臟與透析，25(4)，264-268。doi:10.6340/KD.2013(4).03

Aliasgharpour, M., Abbasi, Z., Razi, S. P., & Kazemnezhad, A. (2016). The effect of stretching exercises on severity of restless legs syndrome in patients on hemodialysis. Asian Journal of Sports Medicine, 7(2), 1-5. https://doi.org/10.5812/asjsm.31001.

Allen, R. P., Picchietti, D. L., Garcia-Borreguero, D., Ondo, W. G., Walters, A. S., Winkelman, J. W.,...International Restless Legs Syndrome Study Group. (2014). Restless legs syndrome/Willis–Ekbom disease diagnostic criteria: Updated International Restless Legs Syndrome Study Group (IRLSSG) consensus criteria–history, rationale, description, and significance. Sleep Medicine, 15(8), 860-873. https://doi.org/10.1016/j.sleep.2014.03.025

Bega, D., & Malkani, R. (2016). Alternative treatment of restless legs syndrome: An overview of the evidence for mind-body interventions, lifestyle interventions, and nutraceuticals. Sleep Medicine, 17, 99-105. https://doi.org/10.1016/j.sleep.2015.09.009

Chu, G., Choi, P., & McDonald, V. M. (2018). Sleep disturbance and sleep-disordered breathing in hemodialysis patients. Seminars in Dialysis, 31(1), 48-58. https://doi.org/10.1111/sdi.12617

國際替代計量

伸展運動介入血液透析患者預防不寧腿症候群再復發之實證照護

全文下載

主題瀏覽