Investigation of the Effect of Reflexology on Fatigue Parameter in Renal Transplantation Patients

Chronic kidney failure (CKD), the incidence of which continues to increase day by day and causes serious health problems in Turkey as in the world, maintains its current status as an important health problem. In the Chronic Kidney Diseases Prevalence (CREDIT) study in Turkey conducted by the Turkish Society of Nephrology (TSN), the incidence of CRF was found to be 15.7%, and the incidence of advanced stage CRF was 5.2%. As it is known, when this health problem reaches the stage of end-stage renal disease (ESRF), one of the renal replacement therapies (RRT) is absolutely needed.

Among the commonly used RRTs today are hemodialysis (HD), peritoneal dialysis (PD) and kidney transplantation (RTx). It has been reported that the best treatment option in terms of quality of life and patient survival is RTx. This is because a successful RTx significantly reduces the risk of mortality and morbidity compared to dialysis. According to the 2020 data of the Ministry of Health, HD was applied to 72.66% of the patients who received RRT, PD to 4.06% and RTx to 23.28%. According to the National Nephrology, Dialysis and Transplant Registration System Report, the number of RTx from live donors in Turkey in 2020 is 2,250 (90.04%), the number of RTx from cadavers is 249 (9.96%), this number is 2,499 in total.

2. BACKGROUND It is known that patients with ESRD likely experience a range of symptoms including nausea, vomiting, pain and fatigue. Therefore, patients prefer RTx more to stop dialysis and maintain a normal life. However, it is stated in the literature that fatigue continues after RTx. Fatigue is a subjective problem that affects individuals physically and psychologically and impairs their quality of life. For this reason, it is very important for nurses who are in constant communication with the patient to evaluate this symptom and to plan and implement appropriate nursing interventions. In this respect, it is recommended to use evidence-based approaches in the prevention and management of fatigue, to repeat the personalized training program at certain intervals, and to use integrative methods that can facilitate coping with fatigue. Exercise, yoga, acupressure and reflexology are among the most preferred integrative methods today. Different studies have reported that patients benefit from reflexology to reduce fatigue.

Reflexology is the method of applying physical pressure to all body parts, organs and reflex points corresponding to the endocrine glands in the ears, hands and feet, which are accepted as the mirror of the body, using certain finger and hand techniques. It has been reported that this approach facilitates relaxation, releases endorphins, modulates pain transmission and pain perception, regulates blood circulation and hemodynamic variables, and improves sleep quality. However, when the literature is examined, it has been seen that there are a limited number of studies evaluating the effect of reflexology in the management of fatigue after RTx. For this reason, this study was conducted to evaluate the effect of reflexology applied to patients who underwent RTx on fatigue, to contribute to fatigue management and to form a basis for future research.

3 STUDY 3.1 Purpose This study will be conducted to examine the effect of reflexology applied to kidney transplant patients on fatigue.