[an error occurred while processing this directive]

Study on symptom group and sentinel symptom of maintenance hemodialysis patients

  • XIAO Wen-Yi ,
  • TAO Xin ,
  • LI Juan-Juan ,
  • WANG Li-Juan ,
  • ZHANG Miao ,
  • GE Yu-Rong
Expand
  • Department of Nursing,Ningxia Medical University, 750004; 2 Blood Purification Center and 3Office of Teacher Development and Teaching Quality Monitoring,Ningxia People's Hospital, 750002

Received date: 2024-10-30

  Revised date: 2025-01-25

  Online published: 2025-04-12

Abstract

Objective  To explore the symptom clusters and their sentinel symptoms in patients undergoing maintenance hemodialysis, providing a reference for the early detection and identification of symptoms, the simplification of symptom cluster management, and the precise management of symptom clusters. Method  The convenience sampling method was adopted to select maintenance hemodialysis patients from the Blood Purification Center of the People's Hospital of Ningxia Hui Autonomous Region. Symptom clusters were extracted by using principal component analysis combined with the orthogonal rotation method of maximum variance. The Apriori algorithm was employed to determine the sentinel symptoms. Result  During dialysis, five symptom clusters were extracted from the patients: the uremic symptom cluster, the emotional symptom cluster, the electrolyte disorder symptom cluster, the gastrointestinal discomfort symptom cluster, and the sleep disorder symptom cluster. Their Cronbach's α coefficients were 0.853, 0.923, 0.850, 0.797, and 0.898, respectively. The results of Apriori correlation analysis and determination showed that skin dryness, anxiety, difficulty in keeping the legs still, constipation, and difficulty in falling asleep were the sentinel symptoms of the above-mentioned symptom clusters in sequence. Conclusion During the dialysis period, maintenance hemodialysis patients experience a variety of symptoms, and each symptom cluster contains sentinel symptoms. In light of this, it is recommended that medical staff in the future consider sentinel symptoms as the starting point for the assessment and management of symptom clusters. Subsequently, corresponding intervention measures can be implemented to enhance the efficiency of symptom management, improve the compliance of MHD patients, thereby reducing patients' disease burden and enhancing their quality of life.

Cite this article

XIAO Wen-Yi , TAO Xin , LI Juan-Juan , WANG Li-Juan , ZHANG Miao , GE Yu-Rong . Study on symptom group and sentinel symptom of maintenance hemodialysis patients[J]. Chinese Journal of Blood Purification, 2025 , 24(04) : 348 -352 . DOI: 10.3969/j.issn.1671-4091.2025.04.019

References

[1] Carletti C O, Rosa C S C, Ramirez A P, et al. Intradialytic exercise and postural control in patients with chronic kidney disease undergoing hemodialysis[J]. Fisioterapia em Movimento, 2017, 30: 247-254.
[2] Le Leu R, Bennett PN, Dansie K, Shanahan L, Chur-Hansen A, Collins KL, Burke ALJ, Donnelly F, Duncanson E, Meade A, McDonald S, Jesudason S. Changes in symptom burden in the first 6 months after dialysis commencement: a prospective longitudinal observational cohort study. J Nephrol. 2023 Jun;36(5):1485-1488.
[3] Hargrove N, El Tobgy N, Zhou O, Pinder M, Plant B, Askin N, Bieber L, Collister D, Whitlock R, Tangri N, Bohm C. Effect of Aerobic Exercise on Dialysis-Related Symptoms in Individuals Undergoing Maintenance Hemodialysis: A Systematic Review and Meta-Analysis of Clinical Trials. Clin J Am Soc Nephrol. 2021 Apr 7;16(4):560-574.
[4] Abdel-Kader, Khaled; Unruh, Mark L.; Weisbord, Steven D. Symptom Burden, Depression, and Quality of Life in Chronic and End-Stage Kidney Disease[J] Clinical Journal of the American Society of Nephrology ,2009,16(4):560-574.
[5] Jim HS, Jacobsen PB, Phillips KM, Wenham RM, Roberts W, Small BJ. Lagged relationships among sleep disturbance, fatigue, and depressed mood during chemotherapy. Health Psychol. 2013 Jul;32(7):768-74.
[6]马景双,王爱平.肺癌术后化疗患者症状群及前哨症状的调查[J].护理学报,2021,28(12):33-37.
[7]费超男,段培蓓,杨玲,等.胃癌化疗患者症状群的研究进[J].2022,37(11):102-105.
[8]王丽娟,张淼,肖雯怡,等.血液透析患者症状群的研究进展[J].中华护理教育,2024,21(01):124-128.
[9]胡霞,罗健,李苗苗,等.肺癌患者症状群管理研究进展[J].护理学杂志,2019,34 (7):99-102.
[10] WEISBORD S D, FRIED L F, ARNOLD R M, et al. Prevalence, severity, and importance of physical and emotional symptoms in chronic hemodialysis patients[J]. J Am Soc Nephrol, 2005,16(8): 2487-2494.
[11]郝艳华.血液透析患者症状的相关研究[D].北京协和医学院,2016.
[12]郑渊,刘可,卜秀青,等.急性白血病患儿化疗期间症状群的调查分析[J].中华护理杂志,2016,51(11):1320-1324.
[13]张浩彬,周伟珠.IBM SPSS Modeler 18.0数据挖掘权威指南[M].北京:人民邮电出版社,2019:356-366.
[14]翟林君,刘蓉,郭傲寒等.维持性血液透析患者的症状群及网络分析[J].护士进修杂志,2023,38(24):2289-2294+2302.
[15] Zhou M, Gu X, Cheng K, Wang Y, Zhang N. Exploration of symptom clusters during hemodialysis and symptom network analysis of older maintenance hemodialysis patients: a cross-sectional study. BMC Nephrol. 2023 Apr 27;24(1):115.
[16]马水梅,杨文君,帕热旦木·托乎提等.基于网络分析维持性血液透析患者症状群及桥梁症状研究[J].中国血液净化,2024,23(03):232-236.
[17] Wong ML, Cooper BA, Paul SM,et al.Differences in Symptom Clusters Identified Using Ratings of Symptom Occurrence versus Severity in Lung Cancer Patients Receiving Chemotherapy[ J ].J Pain Symptom Manage,2017,5
[18] IMAN I S,MONA A I,NEAMA M K,et al.Association of high sensitive C reactive protein and dialysis adequacy with uremic pruritus in hemodialysis patients[J].Alexandria Journal of Medicine,2020,56(1):111-117.
[19]周宇,陈妍伶,叶亚丽,等.干燥综合征患者症状体验的研究进展[J].中国护理管理,2023,23(07):1113-1117.
[20]Narita I,Alchi B,Omori K,et al. Etiology and prognostic sig‐ nificance of severe uremic pruritus in chronic hemodialysis pa‐ tients[J]. Kidney Int,2006,69(9):1626-1632.
[21]EMAN N, FAWZIA F, AHMAD N, et a promising therapy for uremic pruritus in hemodialysis patients:A randomized-controlled trial and review of literature[J].Journal of Dermatological Treatment,2016,27(6):515-519.
[22] Chen J, Liu L, Chen J, Ng MSN, Lou VWQ, Wu B, Jiang W, Jie Y, Zhu J, He Y.
The cross-lagged association between depressive symptoms and healthrelated quality of life in patients receiving maintenance hemodialysis: a three-wave longitudinal study. Qual Life Res. 2021;30(12):3463–73.
[23]高薇,谢席胜.血液透析患者不宁腿综合征发病机制研究进展[J].中国中西医结合肾病杂志,2016,17(6):562-564.
[24]张宝桐,荣阳,刘云霞.血液透析患者合并不安腿综合征的治疗分析与临床研究[J].中国医药指南,2018,16(17):167-168.
[25]梁艳,张小琴.脚踏车运动在维持性血液透析尿毒症并发不安腿综合征患者中的应用效果[J].中国临床护理,2022,14(06):331-333.
[26]邓升华,徐金涛,王东梅,等.耳穴贴压疗法对血液透析病人不安腿综合征的影响[J].护理研究,2023,37(02):367-370.
[27]陈林,曹晓翼,张颖君等.维持性血液透析病人便秘现状及影响因素分析[J].护理研究,2020,34(18):3324-3327
[28]陈家臣,雷子涵,李文豪,等.维持性血液透析患者慢性便秘患病率调查与危险因素分析[J].中华肾脏病杂志,2022,38(10):889-898
[29]Sumida K, Molnar MZ, Potukuchi PK, et al. Constipation and Incident CKD. J Am Soc Nephrol. 2017;28(4):1248-1258. doi:10.1681/ASN.2016060656
[30]尹丽霞,胡晓艳,张海林,等.透析中运动对维持性血液透析患者 透析充分性及睡眠质量的影响[J].中国护理管理,2017,17(11):
1478-1481.
[31]于秀峙,陆石,冯学震,等.尿毒症血液透析患者周围神经病的发生率及影响因素分析[J].临床肾脏病杂志,2017,17(8):486-489.
Outlines

/

[an error occurred while processing this directive]