Effect of Progressive Muscle Relaxation on Fatigue and Sleep Quality in Children Undergoing Hemodialysis

Background: Fatigue and poor sleep quality are more common in children undergoing hemodialysis (HD) than in other healthy children. The management of fatigue and sleep disorders using chemical drugs is mainly costly and associated with medication's side effects, it is necessary to seek out appropriate complementary alternative treatments such as progressive muscle relaxation(PMR). Objective:To investigate the effect of progressive muscle relaxation on fatigue and sleep quality in children undergoing hemodialysis. Setting: The study was carried out at Smouha Children's University Hospital (SCUH) in Alexandria, Egypt. Subjects: A convenient sample of 30 children having an end-stage renal disease (ESRD) undergoing HD who fulfill the following criteria was included: their age ranged from7-15 years old, undergoing HD for at least six months and free from other diseases such as neurological diseases, cerebrovascular accident or mental illness. Tools: three tools were used:“socio-demographic, physiological parameters and medical history of children undergoing hemodialysis structured interview schedule",“Pediatric Quality of Life Inventory (PedsQL) Multidimensional Fatigue Scale" and “Pittsburgh Sleep Quality Index (PSQI) Scale".Results: the result of the current study revealed that, 46.7% of the studied children were aged from 10-12 years.The study showed that the mean percentage score of the overall Pediatric Quality of Life Inventory Multidimensional Fatigue Scale was higher after the application of PMR (84.35 ± 5.80%) which indicate less fatigue, compared with the mean score before (65.09 ± 9.01%) and the difference between before and after was statistically significant (p= <0.001*). Moreover, the mean percentage score of the overall Pittsburgh Sleep Quality Index Scale was lower after application of PMR (14.60 ± 6.49%) which indicate better sleep quality, compared with 30.63 ± 9.98% before application of this technique and the difference between before and after was statistically significant (p= <0.001*). Conclusion: progressive muscle relaxation has significantly decrease fatigue and improve sleep quality among children undergoing hemodialysis. Recommendations: Establishment of hospital administration policies and protocol for non-pharmacological management particularly PMR are recommended to reduce fatigue and improve sleep quality.