• Nephrol. Dial. Transplant. · Jan 2009

    Symptom clusters in incident dialysis patients: associations with clinical variables and quality of life.

    • Melissa S Y Thong, Sandra van Dijk, Marlies Noordzij, Elisabeth W Boeschoten, Raymond T Krediet, Friedo W Dekker, Adrian A Kaptein, and Netherlands Co-operative Study on the Adequacy Study Group.
    • Department of Clinical Epidemiology, Leiden University Medical Centre, Leiden, The Netherlands. S.Y.M.Thong@lumc.nl
    • Nephrol. Dial. Transplant. 2009 Jan 1;24(1):225-30.

    BackgroundTo date, the pathophysiology underlying symptoms in renal patients is still unclear. Symptom management research suggests that identification of related clusters of symptoms could provide insight into underlying determinants associated with multiple symptom experience. Theoretically, symptoms within a cluster could have a synergistic relationship. We aimed to identify symptom clusters in incident dialysis patients, and investigated associations between symptom clusters, clinical variables, functional status as measured by the Karnofsky Index and quality of life.Methods1553 haemodialysis (HD) and peritoneal dialysis (PD) patients completed the Kidney Disease Quality of Life Short Form symptom/problem list at 3 months after the start of dialysis. Principal component analysis using varimax rotation was used to identify symptom clusters.ResultsPatients were bothered by an average of 2.8 (+/-2.4) symptoms of 'moderate bother' or more. Three clusters were identified, explaining 49% of the total variance. All clusters showed strong negative associations with the SF-36 quality of life dimensions (-0.142 to -0.593) and with functional status (-0.130 to -0.332) in HD and PD patients. In contrast, only the clinical variables serum albumin (-0.084 to -0.232) and haemoglobin (-0.068 to -0.126) were associated with all clusters in HD patients, and Kt/V(urea) (-0.089 to -0.125) in PD patients.ConclusionsSymptom clustering does not explain the lack of meaningful associations between symptoms and clinical variables. Strong associations of symptom clusters with quality of life dimensions suggest that psychological factors could better explain symptom burden. Patients' perceptions of symptoms should be routinely assessed as part of clinical care to improve self-management strategies.

      Pubmed     Free full text   Copy Citation     Plaintext  

      Add institutional full text...

    Notes

     
    Knowledge, pearl, summary or comment to share?
    300 characters remaining
    help        
    You can also include formatting, links, images and footnotes in your notes
    • Simple formatting can be added to notes, such as *italics*, _underline_ or **bold**.
    • Superscript can be denoted by <sup>text</sup> and subscript <sub>text</sub>.
    • Numbered or bulleted lists can be created using either numbered lines 1. 2. 3., hyphens - or asterisks *.
    • Links can be included with: [my link to pubmed](http://pubmed.com)
    • Images can be included with: ![alt text](https://bestmedicaljournal.com/study_graph.jpg "Image Title Text")
    • For footnotes use [^1](This is a footnote.) inline.
    • Or use an inline reference [^1] to refer to a longer footnote elseweher in the document [^1]: This is a long footnote..

    hide…