Abstract:

Objective To evaluate the effect of difference non-pharmacological interventions on fatigue of patients with maintenance hemodialysis by network meta-analysis. Methods The PubMed，Embase，Web of Science，Cochrane，CNKI，VIP，Wanfang data，SinoMed and CINAHL were electronically searched to collect articles on non-pharmacological interventions for fatigue management in patients with maintenance hemodialysis before February 2022. Two researchers screened the articles，evaluated the quality of the included studies，as well as extracted and analyzed the data independently. Results A total of 27 articles and 13 kinds of non-pharmacological interventions were included，with a total of 2，315 patients. The results of network meta-analysis showed that the effects of acupuncture，aromatherapy，muscle relaxation training，acupressure massage，aerobic exercise were better than those of routine care（P<0.05）. Furthermore，compared with other 12 measures，acupuncture showed significantly stronger effects on fatigue（P<0.05）. The top three interventions were acupuncture，aromatherapy，and muscle relaxation training. Conclusions Acupuncture，aromatherapy，muscle relaxation training，acupoint massage，and routine aerobic exercise are more effective than routine interventions in relieving fatigue in patients with maintenance hemodialysis. Acupuncture has the best effect on fatigue；however，the conclusion needs to be further verified by high-quality RCTs with multi-centers and large sample size.

Key words: Hemodiafiltration, Patients, Fatigue, Evidence-Based Nursing, Non-pharmacological interventions