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探索中国腹膜透析患者的症状群:网络分析。

Exploring symptom clusters in Chinese patients with peritoneal dialysis: a network analysis.

机构信息

Department of Nephrology, Kidney Research Institute, West China Hospital of Sichuan University/West China School of Nursing, Sichuan University, Chengdu, China.

Mianyang Central Hospital, Mianyang, China.

出版信息

Ren Fail. 2024 Dec;46(1):2349121. doi: 10.1080/0886022X.2024.2349121. Epub 2024 Jun 25.

Abstract

BACKGROUND

In recent years, the research on symptom management in peritoneal dialysis (PD) patients has shifted from a single symptom to symptom clusters and network analysis. This study collected and evaluated unpleasant symptoms in PD patients and explored groups of symptoms that may affect PD patients with a view to higher symptom management.

METHODS

The symptoms of PD patients were measured using the modified Dialysis Symptom Index. The symptom network and node characteristics were assessed by network analysis, and symptom clusters were explored by factor analysis.

RESULTS

In this study of 602 PD patients (mean age 47.8 ± 16.8 years, 47.34% male), most had less than 2 years of dialysis experience. Five symptom clusters were obtained from factor analysis, which were body symptom cluster, gastrointestinal symptom cluster, mood symptom cluster, sexual disorder symptom cluster, and skin-sleep symptom cluster. Itching and decreased interest in sex may be sentinel symptoms, and being tired or lack of energy and feeling anxious are core symptoms in PD patients.

CONCLUSIONS

This study emphasizes the importance of recognizing symptom clusters in PD patients for better symptom management. Five clusters were identified, with key symptoms including itching, decreased interest in sex, fatigue, and anxiety. Early intervention focused on these symptom clusters in PD patients holds promise for alleviating the burden of symptoms.

摘要

背景

近年来,腹膜透析(peritoneal dialysis,PD)患者症状管理的研究已从单一症状转向症状群和网络分析。本研究收集和评估了 PD 患者的不愉快症状,并探讨了可能影响 PD 患者的症状群,以期实现更高水平的症状管理。

方法

使用改良的透析症状指数(Dialysis Symptom Index)测量 PD 患者的症状。通过网络分析评估症状网络和节点特征,并通过因子分析探索症状群。

结果

在这项纳入 602 例 PD 患者(平均年龄 47.8±16.8 岁,47.34%为男性)的研究中,大多数患者的透析时间不足 2 年。通过因子分析得到了 5 个症状群,分别是身体症状群、胃肠道症状群、情绪症状群、性功能障碍症状群和皮肤-睡眠症状群。瘙痒和性兴趣降低可能是首发症状,而疲倦或乏力和焦虑是 PD 患者的核心症状。

结论

本研究强调了认识 PD 患者症状群对于更好地进行症状管理的重要性。确定了 5 个症状群,其关键症状包括瘙痒、性兴趣降低、疲倦和焦虑。早期针对这些症状群对 PD 患者进行干预有望减轻症状负担。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4e95/11207921/aaedc00468e2/IRNF_A_2349121_F0001_C.jpg

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