Impatto del trattamento emodialitico sulla qualità della vita: fatica cronica e sistema di reward

[Autom. eng. transl.] Hemodialysis allows patients with end-stage renal insufficiency a good level of survival. However, the treatment strongly influences the patient's quality of life (QoL). Most patients undergoing hemodialysis (HD) suffer from chronic fatigue. Fatigue, besides being a "physical" symptom, is also "motivational" and is often associated with pain, affective and cognitive alterations. Furthermore, studies on neuro-immune interactions have shown that, in chronic diseases of this magnitude, an alteration of the function of the basal ganglia can compromise the functioning of the reward system (reward). This study evaluates in HD patients the possible correlation between fatigue and reward mechanisms underlying the motivational disposition. Evaluation scales were administered to a sample of middle aged patients (N = 94). The Fatigue Severity Scale (FSS) was used to measure the impact of fatigue on patient motivation. The Behavioral Activation System (BAS) and Behavioral Inhibition System (BIS) scale was administered to investigate the mechanisms of motivational disposition of approach / avoidance to rewards and punishments. Finally, to assess the possible presence of anxiety and depressive disorders, the State-Trait Anxiety Inventory (STAI-Y) and the Back Depression Inventory (BDI-II) were used. The FSS score was significantly higher in patients with high BIS score than in patients with a low and intermediate BIS score. In contrast, the BDI and STAI-Y1 / Y2 scores are similar between groups of patients with high, intermediate and low BIS scores. The correlation between the BIS score and the FSS score was statistically significant. This study demonstrates the existence of a correlation between fatigue symptoms and reward mechanisms with possible consequences on the behavior and QoL of HD patients.