Department of Nursing Science, Faculty of Medicine, University of Malaya, Kuala Lumpur 50603, Malaysia.
Department of Nursing, Faculty of Allied Health Sciences, University of Peradeniya, Peradeniya 20400, Sri Lanka.
Int J Environ Res Public Health. 2022 May 3;19(9):5540. doi: 10.3390/ijerph19095540.
People with end stage renal disease and undergoing hemodialysis experience a high symptom burden that impairs quality of life. This study aimed to assess the prevalence, dynamicity and determinants of symptom burden among middle-aged and older adult hemodialysis patients. A descriptive cross-sectional study together with a longitudinal assessment was used. A total of 118 and 102 hemodialysis patients were assessed at baseline and at a 6-month follow-up. Validated questionnaires were used to assess the symptom burden, stress, illness perception and social support. Multiple linear regression analysis was used to determine the factors associated with symptom burden. The median number of symptoms experienced was 21 (Interquartile Range (IQR); 18−23) and 19 (IQR; 13−22) at baseline and 6 months, respectively. Having elevated stress (β = 0.65, p ≤ 0.005) and illness perception (β = 0.21, p = 0.02) were significantly predicted symptom burden at baseline (F (4, 112) = 55.29, p < 0.005, R2 = 0.664). Stress (β = 0.28, p = 0.003), illness perception (β = 0.2, p = 0.03), poor social support (β = −0.22, p = 0.01) and low body weight (β = −0.19, p = 0.03) were the determinants for symptom burden at 6 months (F (5, 93) = 4.85, p ≤ 0.005, R2 = 0.24). Elevated stress, illness perception level, poor social support and low post-dialysis body weight were found to be determinants for symptom burden. Attention should be given to psychosocial factors of hemodialysis patients while conducting assessment and delivering care to patients.
患有终末期肾病并接受血液透析的患者经历着较高的症状负担，这会降低他们的生活质量。本研究旨在评估中年和老年血液透析患者的症状负担的流行率、动态变化和决定因素。本研究采用了描述性的横断面研究和纵向评估。共有 118 名和 102 名血液透析患者分别在基线和 6 个月随访时进行了评估。采用经过验证的问卷评估了症状负担、压力、疾病认知和社会支持情况。采用多元线性回归分析确定了与症状负担相关的因素。在基线和 6 个月时，患者经历的症状中位数分别为 21（IQR；18-23）和 19（IQR；13-22）。基线时，较高的压力（β=0.65，p≤0.005）和疾病认知（β=0.21，p=0.02）显著预测了症状负担（F（4，112）=55.29，p＜0.005，R2=0.664）。压力（β=0.28，p=0.003）、疾病认知（β=0.2，p=0.03）、较差的社会支持（β=-0.22，p=0.01）和较低的透析后体重（β=-0.19，p=0.03）是 6 个月时症状负担的决定因素（F（5，93）=4.85，p≤0.005，R2=0.24）。研究发现，较高的压力、疾病认知水平、较差的社会支持和透析后较低的体重是症状负担的决定因素。在对血液透析患者进行评估和提供护理时，应关注其心理社会因素。
