Jablonski Anita
Seattle University College of Nursing, Seattle, Washington, USA.
Nephrol Nurs J. 2007 Jan-Feb;34(1):29-37; quiz 38.
Contemporary theoretical models conceptualize symptoms as multidimensional interactive phenomena. This research examined the symptoms experienced by patients on hemodialysis within this paradigm. The intensity (severity), timing (frequency and duration), distress (bother), and concurrence (co-occurring symptoms) associated with symptoms were explored. A multidimensional profile constructed for each of the symptoms demonstrated that those rated as the most severe were not necessarily the most frequently occurring, longest lasting, or most distressing to patients. Symptoms also occurred in groups. Patients reported individual symptoms as increasingly troublesome and quality of life progressively lower as they experienced more of the symptoms in a grouping. These findings suggest the need to view patients' symptom experiences more broadly. Symptom assessment should include the full complement of symptoms patients experience and move beyond the current practice of assessment of severity alone to include all symptom dimensions.
当代理论模型将症状概念化为多维交互现象。本研究在此范式下考察了血液透析患者所经历的症状。探讨了与症状相关的强度（严重程度）、时间（频率和持续时间）、困扰（烦恼程度）和并发情况（同时出现的症状）。为每种症状构建的多维概况表明，那些被评为最严重的症状不一定是最常出现、持续时间最长或对患者困扰最大的症状。症状也会成组出现。患者报告称，随着他们在一组症状中经历的症状越多，个体症状就越发困扰，生活质量也逐渐降低。这些发现表明有必要更全面地看待患者的症状体验。症状评估应包括患者经历的所有症状，而不仅仅是目前仅评估严重程度的做法，还应涵盖所有症状维度。
