Department of Nephrology, Eulji General Hospital, Eulji University School of Medicine, Seoul, South Korea.
Department of Nursing, College of Nursing, Eulji University, Seongnam, South Korea.
J Clin Nurs. 2018 May;27(9-10):2132-2141. doi: 10.1111/jocn.13904. Epub 2017 Aug 31.
To identify the characteristics in each symptom cluster and factors influencing the quality of life of haemodialysis patients in Korea according to cluster.
Despite developments in renal replacement therapy, haemodialysis still restricts the activities of daily living due to pain and impairs physical functioning induced by the disease and its complications.
Descriptive survey. Two hundred and thirty dialysis patients aged >18 years. They completed self-administered questionnaires of Dialysis Symptom Index and Kidney Disease Quality of Life instrument-Short Form 1.3.
To determine the optimal number of clusters, the collected data were analysed using polytomous variable latent class analysis in R software (poLCA) to estimate the latent class models and the latent class regression models for polytomous outcome variables. Differences in characteristics, symptoms and QOL according to the symptom cluster of haemodialysis patients were analysed using the independent t test and chi-square test. The factors influencing the QOL according to symptom cluster were identified using hierarchical multiple regression analysis.
Physical and emotional symptoms were significantly more severe, and the QOL was significantly worse in Cluster 1 than in Cluster 2. The factors influencing the QOL were spouse, job, insurance type and physical and emotional symptoms in Cluster 1, with these variables having an explanatory power of 60.9%. Physical and emotional symptoms were the only influencing factors in Cluster 2, and they had an explanatory power of 37.4%.
Mitigating the symptoms experienced by haemodialysis patients and improving their QOL require educational and therapeutic symptom management interventions that are tailored according to the characteristics and symptoms in each cluster.
The findings of this study are expected to lead to practical guidelines for addressing the symptoms experienced by haemodialysis patients, and they provide basic information for developing nursing interventions to manage these symptoms and improve the QOL of these patients.
根据聚类分析确定韩国血液透析患者每个症状群的特征以及影响其生活质量的因素。
尽管肾脏替代疗法有所发展，但由于疼痛以及疾病及其并发症导致的身体机能障碍，血液透析仍然限制了患者的日常生活活动。
描述性调查。230 名年龄大于 18 岁的透析患者。他们完成了自我管理的透析症状指数和肾脏病生活质量量表-短表 1.3 的问卷调查。
为了确定最佳聚类数量，使用 R 软件中的多项式变量潜在类别分析（poLCA）对收集的数据进行分析，以估计潜在类别模型和多项式因变量的潜在类别回归模型。使用独立 t 检验和卡方检验分析血液透析患者症状聚类的特征、症状和生活质量差异。使用分层多重回归分析确定影响症状聚类生活质量的因素。
与聚类 2 相比，聚类 1 中的身体和情绪症状更为严重，生活质量更差。影响聚类 1 生活质量的因素有配偶、工作、保险类型以及身体和情绪症状，这些变量的解释能力为 60.9%。身体和情绪症状是聚类 2 的唯一影响因素，解释能力为 37.4%。
缓解血液透析患者的症状并提高其生活质量需要根据每个聚类的特点和症状进行教育和治疗性症状管理干预。
本研究的结果有望为解决血液透析患者的症状提供实用指南，并为开发管理这些症状和提高这些患者生活质量的护理干预措施提供基本信息。
