| Objective:1. To investigate the occurrence of symptoms and identifysymptom clusters among maintenance hemodialysis patients.2. To surveythe symptom burden and quality of life of patients on maintenancehemodialysis, analyze symptom burden’s related factors and relevancy withthe quality of life.Methods:1. A convenience sample of280hemodialysis patientscompleted the Dialysis Symptom index (DSI) and a self-designed generalinformation questionnaire. General demographic information, the incidenceand severity of symptoms were analyzed for descriptive statistics. TheSpearman correlation coefficient between symptoms severity scores andtotal score greater than0.3were entered into the factor analysis (FA),using exploratory factor analysis method to determine the symptom clusters.2. Totally136patients on hemodialysis were investigated with generalinformation questionnaire, Dialysis Frequency, Severity and SymptomBurden Index(DFSSBI)，as well as the MOS36-item Short Form HealthSurvey(SF-36). Analysis the symptom burden with relevance to the general demographic information and quality of life.Results:1. Five symptom clusters emerged from the factor analysis:emotional symptom cluster, General symptoms of uraemic syndromecluster, digestive symptom cluster, cardiac-pulmonary symptom cluster andwater-electrolyte symptom cluster.(1) Emotional symptom cluster,including5symptoms. The symptoms occur in frequency from high to lowin turn for: feeling irritable (48.9%), feeling anxious (42.9%), worrying(41.1%), feeling sad (41.1%), feeling nervous (28.9%).(2) Generalsymptoms of uraemic syndrome cluster, including8symptoms. Thesymptoms occur in frequency from high to low in turn for: dry skin(75.7%), itching (73.2%), trouble staying sleep (63.2%), trouble fallingsleep (62.5%), feeling tried or lack of energy (61.4%), bone or joint pain(46.4%), muscle soreness (46.1%), numbness or tingling in feet (33.6%).(3)Digestive symptom cluster, including3symptoms. The symptoms occur infrequency from high to low in turn for: decreased appetite (46.8%), nausea(41.8%), vomiting (29.3%).(4) cardiac-pulmonary symptom cluster,including3symptoms. The symptoms occur in frequency from high to lowin turn for: headedness or dizziness (48.2%), shortness of breath (34.6%),chest pain (19.3%).(5) water-electrolyte symptom cluster, including3symptoms. The symptoms occur in frequency from high to low in turn for:swelling in legs (53.6%), muscle cramps (49.3%), restless legs (35.4%).2.The symptom burden score in all hemodialysis patients was (75.63±32.25), symptom frequency was (26.07±11.64), symptom severity was (23.05±9.69), symptom distress was (26.51±11.49). The score of quality of lifewas (53.32±16.80). Multivariable stepwise regression showed there werestatistically significant correlation between the symptom burden andincome, work status, age and gender（P＜0.05）3. Pearson correlationanalysis demonstrated that symptom burden score was negativelycorrelated with the quality of life, including physical function, role physical,bodily pain, general health, vitality, social function, role emotional andmental health.Conclusion:1. Maintenance hemodialysis patients experiencedseveral symptoms at the same time, which can be gathered into clusters.Medical staff should construct nursing intervention measures to ensure theeffective symptom management.2. According to these data, themaintenance hemodialysis patients have a poor quality of life and suffer aserious burden of symptoms, especially in those who are jobless, withlower income and advanced age.3. The symptom frequency, severity anddistress of patients on hemodialysis were negatively correlated with thequality of life. Grater attention should be given to assessment andmanagement of symptom burden and improve the quality of life ofhemodialysis patients. |
PDF Full Text Request