Effect of an integrated qigong and body scan program on fatigue levels among patients with chronic kidney disease undergoing hemodialysis

Authors

  • ฺBorwarnluck Thongthawee Faculty of Nursing, Thammasat University, Khlong Luang, Pathumthani, Thailand
  • Yaowarat Matchim Faculty of Nursing, Thammasat University, Khlong Luang, Pathumthani, Thailand
  • Pattharawin Pattharanitima Faculty of Medicine, Thammasat University, Khlong Luang, Pathumthani, Thailand
  • Montira Khianlikit Department of Nursing, Thammasat University Hospital, Khlong Luang, Pathumthani, Thailand
  • Thanarak Boonkerd Department of Nursing, Thammasat University Hospital, Khlong Luang, Pathumthani, Thailand

Keywords:

qigong, body scan, fatigue, chronic kidney disease, hemodialysis

Abstract

This quasi-experimental design with a two-group pretest-posttest, aimed to examine effects of an integrated qigong and body scan program on fatigue level among patients with chronic kidney disease undergoing hemodialysis at The Hemodialysis Center in Thammasat University Hospital, Pathum Thani Province, Thailand. A total of 67 participants with chronic kidney disease undergoing hemodialysis were selected through purposive sampling based on inclusion criteria. Participants were assigned to either the experimental group, which received an integrated qigong and body scan for 12 weeks (n = 33), or the control group, which received standard care (n = 34). The instruments used for data collection included: 1) a 12-week Integrated Qigong and Body Scan, and 2) a characteristics data questionnaire and the Fatigue Assessment Scale (FAS). Descriptive statistics and t-tests were used to analyze the data.

The results revealed that before the intervention, the mean fatigue score in the experimental group was 132.94 (S.D. = 18.86), which decreased to 42.18 (S.D. = 8.34) after participation in the program. In contrast, the control group had a mean fatigue score of 129.21 (S.D. = 23.08) before and 129.41 (S.D. = 22.89) after participation of the program. The mean fatigue score in the experimental group decreased significantly (t = 40.61, p < 0.001) and differed significantly from the control group (t = -20.64, p < 0.001).

This study suggests that an integrated qigong and body scan program may be beneficial in reducing fatigue among patients with chronic kidney disease undergoing hemodialysis. Healthcare providers should consider implementing this practice in hemodialysis centers.

References

Vijitsoonthornkul K. Epidemiology and revision of standard for prevention in chronic renal failure. Bureau of Non-Communicable Diseases [internet]. 2021 [cited 2023 May 13]. Available from: https://ddc.moph.go.th/uploads/publish/1308820220905025852.pdf. (in Thai).

The Nephrology Society of Thailand. Clinical practice recommendation for the evaluation and management of chronic kidney disease in adults 2022 [internet]. 2022 [cited 2024 March 23]. Available from: https://www.nephrothai.org/wp-content/uploads/2023/03/CKD-guideline-2565-revised-edition.pdf. (in Thai).

The Nephrology Society of Thailand. Thailand renal replacement therapy year 2020 [internet]. [cited 2024 May 17]. Available from: https://www.nephrothai.org/wp-content/uploads/2021/01/1.TRT-Annual-report-2016-2019.pdf. (in Thai).

Mahathanan N, Krayprayong P. Nursing practice recommendation for hemodialysis and peritoneal dialysis. 1st edition. Bangkok: Bangkok Medical Publisher; 2022. (in Thai).

Ju A, Teixeira-Pinto A, Tong A, Smith AC, Unruh M, Davison SN, et al. Validation of a core patient-reported outcome measure for fatigue in patients receiving hemodialysis: the SONG-HD fatigue instrument. Clin J Am Soc Nephrol. 2020 Nov;15(11):1614-21. doi: 10.2215/CJN.05880420.

Bossola M, Hedayati SS, Brys AD, Gregg LP. Fatigue in patients receiving maintenance hemodialysis: a review. Am J Kidney Dis. 2023 Oct;82(4):464-80. doi: 10.1053/j.ajkd.2023.02.008.

Alshammari B, Alkubati SA, Alrasheeday A, Pasay-An E, Edison JS, Madkhali N, Al-Sadi AK, Altamimi MS, Alshammari SO, Alshammari AA, Alshammari F. Factors influencing fatigue among patients undergoing hemodialysis: a multi-center cross-sectional study. Libyan J. Med. 2024; 19(1):2301142. doi: 10.1080/19932820.2023.2301142

Zheng XY, Zhang ZH, Cheng YM, Yang Q, Xu B, Lai BC, Huang LT. Factors associated with subgroups of fatigue in maintenance hemodialysis patients: a cross-sectional study. Ren Fail. 2023; 45(1):2221129. doi: 10.1080/0886022X.2023.222112

Yang P. Healthy by Qigong: easy Guang-Im Ju-Jai-Gong. 7th Edition. Bangkok: Best graphic press; 2012. (in Thai).

Lauche R, Peng W, Ferguson C, Cramer H, Frawley J, Adams J, Sibbritt D. Efficacy of Tai Chi and qigong for the prevention of stroke and stroke risk factors: a systematic review with meta-analysis. Medicine. (Baltimore).2017; 96(45), e8517. doi: 10.1097/MD.0000000000008517

Tao S, Li Z. Effects of qigong exercise on cardiovascular risk factors in patients with metabolic syndrome: a systematic review and meta-analysis. Front Physiol. 2023; 14, 1092480. doi: 10.3389/fphys.2023.1092480

Oh B. Bae K. Lamoury G, Eade T, Boyle F, Corless B, Back M. The effects of tai chi and qigong on immune responses: a systematic review and meta-analysis. Medicines. (Basel). 2020; 7(7), 39. doi: 10.3390/medicines7070039

Wang R, Huang X, Wu Y, Sun D. Efficacy of qigong exercise for treatment of fatigue: a systematic review and meta-analysis. Front Med. 2021; 8, 684058. doi: 10.3389/fmed.2021.684058

Gan R, Zhang L, Chen S. The effects of body scan meditation: a systematic review and meta-analysis. Appl Psychol Health and Well Being. 2022; 14(3):1062-80. doi: 10.1111/aphw.12366

Alhawatmeh H, Alshammari S, Rababah JA. Effects of mindfulness meditation on trait mindfulness, perceived stress, emotion regulation, and quality of life in hemodialysis patients: a randomized controlled trial. Int J Nurs Sci. 2022; 9(2):139-46. doi: 10.1016/j.ijnss.2022.03.004

Razzera BN, Adamoli AN, Ranheiri MF, Oliveira, MDS, Feoli AMP. Impacts of mindfulness-based interventions in people undergoing hemodialysis: a systematic review. Braz. J. Nephrol. 2021; 44(1):84-96. doi: 10.1590/2175-8239-JBN-2021-0116

Thammasat University Hospital. Renal replacement theraphy unit: annual report. 2017. (in Thai)

Polit DF, Beck CT. Nursing research: generating and assessing evidence for nursing practice. Philadelphia: Wolters Kluwer; 2017.

Bayoumi MM, Wakeel JS. Impacts of exercise programs on hemodialysis patients' quality of life and physical fitness. Qual Prim Care. [Internet]. 2015 [cited 2025 Apr 3]; 23(4):192-200. Available from: https://www.primescholars.com/articles/impacts-of-exercise-programs-on-hemodialysispatients-quality-of-life-and-physical-fitness-100323.html

Poosumang T. Effects of using exercise and health education program on fatigue of acute myocardial infarction patients. [Master Thesis of Nursing Science]. Bangkok: Chulalongkorn University; 2003. (in Thai). Available from: https://cuir.car.chula.ac.th/handle/123456789/1882

Soliman HM. Effect of intradialytic exercise on fatigue, electrolytes level and blood pressure in hemodialysis patients: a randomized controlled trial. J Nurs Educ Pract. 2015; 5(11):16-28. doi: 10.5430/jnep.v5n11p16

Mangalvedhe PV, Shetty MS, Balakrishnan DC. Impact of exercise on fatigue in patients undergoing dialysis in a tertiary care hospital. Cureus. 2023; 15(2), e35004. doi: 10.7759/cureus.35004

Wilkinson TJ, Watson EL, Gould DW, Xenophontos S, Clarke L, Vogt BP, Viana JL, Smith AC. Twelve weeks of supervised exercise improves self-reported symptom burden and fatigue in chronic kidney disease: a secondary analysis of the ‘ExTra CKD’trial. Clin Kidney J. 2019; 12(1):113-21. doi: 10.1093/ckj/sfy071

Serin EK, Ovayolu N, Ovayolu Ö. The effect of progressive relaxation exercises on pain, fatigue, and quality of life in dialysis patients. Holist Nurs Pract. 2020; 34(2):121-128. doi: 10.1097/HNP.0000000000000347

Wu CY, Han HM, Huang MC, Chen YM, Yu WP, Weng LC. Effect of qigong training on fatigue in haemodialysis patients: a non-randomized controlled trial. Complement Ther Med. 2014; 22(2):244-50. doi: 10.1016/j.ctim.2014.01.004

Zhang J. Su Q, Li SC. Qigong exercise balances oxygen supply and acid-base to modulate hypoxia: a perspective platform toward preemptive health & medicine. Med Sci. 2023; 11(1), 21. doi: 10.3390/medsci11010021.

Leong PK, Wong HS, Chen J, Ko KM. Yang/Qi invigoration: an herbal therapy for chronic fatigue syndrome with yang deficiency? eCAM. 2015; 1, 945901. doi: 10.1155/2015/945901

Elgueta-Cancino E, Evans E, Martinez-Valdes E, Falla D. The effect of resistance training on motor unit firing properties: a systematic review and meta-analysis. Front Physiol. 2022; 13, 817631. doi: 10.3389/fphys.2022.817631

Guendelman S, Medeiros S, Rampes H. Mindfulness and emotion regulation: insights from neurobiological, psychological, and clinical studies. Front Psychol. 2017; 8, 220. doi: 10.3389/fpsyg.2017.00220

Downloads

Published

2025-08-03

How to Cite

1.
Thongthawee ฺ, Matchim Y, Pattharanitima P, Khianlikit M, Boonkerd T. Effect of an integrated qigong and body scan program on fatigue levels among patients with chronic kidney disease undergoing hemodialysis. Thai J Cardio-Thorac Nurs. [internet]. 2025 Aug. 3 [cited 2026 Jan. 15];36(1):141-57. available from: https://he02.tci-thaijo.org/index.php/journalthaicvtnurse/article/view/272313

Issue

Section

Research Articles