Background: Fatigue is the most common among the many troublesome symptoms experienced by patients undergoing hemodialysis, and this can significantly decrease the patient’s quality of life.
Purpose: The purpose of this study was to identify the severity of fatigue and it’s associated in physiological, psychological and situational factors among patients undergoing HD in Indonesia.
Method: To achieve these goals a cross-sectional study was conducted. This study examined 140 patients with End Stage Renal Disease (ESRD) undergoing routine hemodialysis. Three questionnaires and one scoring system were used in this study. Fatigue was assessed using the 4th version of the Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-F). The Depression, Anxiety and Stress Scale-Short Form (DASS-SF) was used to measure psychological factors. The Charlson Comorbidity Index (CCI) was used to measure comorbidity among clients undergoing hemodialysis. Bivariate and multivariate analyses were used to assess the associations between independent variables and fatigue, and to find the predictors of fatigue among the various physical, psychological, and situational factors.
Result: The results showed that among the situational factors, namely the demographic factors, length of hemodialysis and frequency of hemodialysis, age was significantly associated (r = .204, p = .015) and becomes a predictor of fatigue (β = .13, p = < .05). The psychological factors such as depression, anxiety and stress were highly correlated with fatigue but only anxiety (β = .886, p = < .001) becomes a predictor of fatigue. Finally, the physiological factors namely urea, creatinin, hemoglobin, and comorbidity, both comorbidity (β = .1.56, p = < .001) and hemoglobin level (β = -.593, p = < .001) were predictors of fatigue.
Conclusions: Age, hemoglobin, comorbidity, and anxiety have significant associations with fatigue and also predictors of fatigue. Improving these may thus reduce fatigue and increase the quality of life in patients undergoing routine hemodialysis.

Keywords: Fatigue, Patients with routine hemodialysis.

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