Association between fatigue, motivational measures (BIS/BAS) and semi-structured psychosocial interview in hemodialytic treatment

Background: Nowadays there is a growing interest in exploring causes of fatigue symptoms and the possible linked aspects in patients with Chronic Kidney Disease (CKD) receiving hemodialysis (HD) treatment. Inflammatory processes were demonstrated to influence motivational systems functioning in chronic conditions. However, there is a lack of connection between quantitative motivational systems measure and patients self-report motivational and fatigue issue. Thus, the aim of this study was to identify an association between HD patients reward mechanisms, fatigue severity and psychosocial variables emerging from semi-structured interviews. Methods: Interviews were held for a sample of ninety-four patients (54 males, 40 females; Mage = 62.98 ± 17.94; dialytic mean age in months = 76.55 ± 84.89) receiving chronic HD treatment and consequently analyzed by means of quantitative and qualitative analysis. Behavioral motivation systems reflecting inhibition/approach tendency to rewards were measured by Behavioral Inhibition/Activation System (BIS/BAS) scale and the fatigue severity experienced by HD patients was measured with the Fatigue Severity Scale. Scale results were correlated to psychosocial variables and topics derived from the semi-structured interviews. Results: Findings highlight the presence of two effects: one related to the Behavioral Activation System (BAS) as a protective factor against the HD treatment pervasive consequences; the other one deals with the self-reported levels of fatigue that seemed to significantly interfere with patients’ daily life, as a function of gender. Conclusions: Such results encourage the use of a mixed method approach to understand the complexity of the subjective experience of patients’ facing chronic disease and treatments.