Department of Nursing, Chang Gung University of Science and Technology, Taoyuan, Taiwan.
Department of Nephrology, Chang Gung Memorial Hospital, Taoyuan, Taiwan.
PLoS One. 2020 Feb 7;15(2):e0228259. doi: 10.1371/journal.pone.0228259. eCollection 2020.
To classify hemodialysis patients into subgroups via cluster analysis according to the Somatic Symptoms Disturbance Index, Taiwanese Depression Scale, and Herth Hope Index scores. Patient demands in each cluster were also examined.
Overall patient demands among hemodialysis patients have been demonstrated in numerous reports; however, variables among subgroups have not been explored.
Data were analyzed from a cross-sectional survey of 114 hemodialysis patients recruited from dialysis centers in Northern Taiwan. Hope, depression, and symptom disturbance were used as parameters for clustering because they have been shown to be important factors affecting patient demands. A two-step cluster analysis was performed to classify participants into clusters. Patient demands in each cluster were analyzed.
Among the 114 participants, there was a negative correlation between hope and depression as well as between hope and symptom disturbance; there was a positive correlation between depression and symptom disturbance. Two clusters were identified: Cluster 1 (n = 49) included patients with moderate levels of hope and symptom disturbance, and high levels of depression; and Cluster 2 (n = 65) included patients with low levels of depression and symptom disturbance and high levels of hope. Demographic profiles differed between the two clusters. Regarding patient demands, medical demand showed the highest average score; whereas, occupational demand exhibited the lowest average score. Psychological and occupational demands differed significantly between the two clusters. The two clusters were defined as subgroups: Cluster 1 was labeled "resting"; Cluster 2 was labeled "active".
Cluster analysis may further classify hemodialysis patients into distinct subgroups base on their specific patient demands. A better understanding of patient demands may help health professionals to provide a holistic individualized treatment to improve patients' outcomes.
根据躯体症状障碍指数、台湾版抑郁量表和 Herth 希望指数的评分，通过聚类分析将血液透析患者分为亚组。还检查了每个亚组中患者的需求。
许多报告已经证明了血液透析患者的总体患者需求；然而，尚未探讨亚组之间的变量。
对来自台湾北部透析中心的 114 名血液透析患者进行的横断面调查数据进行了分析。希望、抑郁和症状障碍被用作聚类的参数，因为它们已被证明是影响患者需求的重要因素。进行两步聚类分析将参与者分为亚组。分析每个聚类中的患者需求。
在 114 名参与者中，希望与抑郁以及希望与症状障碍之间呈负相关；抑郁与症状障碍之间呈正相关。确定了两个聚类：聚类 1（n=49）包括希望和症状障碍水平中等但抑郁水平高的患者；聚类 2（n=65）包括抑郁和症状障碍水平低但希望水平高的患者。两个聚类的人口统计学特征不同。关于患者需求，医疗需求的平均得分最高；而职业需求的平均得分最低。两个聚类之间的心理和职业需求存在显著差异。这两个聚类被定义为亚组：聚类 1 被标记为“休息”；聚类 2 被标记为“活跃”。
聚类分析可以根据患者的特定需求进一步将血液透析患者分为不同的亚组。更好地了解患者需求可能有助于卫生专业人员提供整体个性化治疗，以改善患者的预后。
