Exploration of symptom clusters during hemodialysis and symptom network analysis of older maintenance hemodialysis patients: a cross-sectional study
Abstract Background Symptom networks can provide empirical evidence for the development of personalized and precise symptom management strategies. However, few studies have established networks of symptoms experienced by older patients on maintenance hemodialysis. Our goal was to examine the type of...
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| Format: | Article |
| Language: | English |
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BMC
2023-04-01
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| Series: | BMC Nephrology |
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| Online Access: | https://doi.org/10.1186/s12882-023-03176-4 |
| _version_ | 1797836556566790144 |
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| author | Mingyao Zhou Xiaoxin Gu Kangyao Cheng Yin Wang Nina Zhang |
| author_facet | Mingyao Zhou Xiaoxin Gu Kangyao Cheng Yin Wang Nina Zhang |
| author_sort | Mingyao Zhou |
| collection | DOAJ |
| description | Abstract Background Symptom networks can provide empirical evidence for the development of personalized and precise symptom management strategies. However, few studies have established networks of symptoms experienced by older patients on maintenance hemodialysis. Our goal was to examine the type of symptom clusters of older maintenance hemodialysis patients during dialysis and construct a symptom network to understand the symptom characteristics of this population. Methods The modified Dialysis Symptom Index was used for a cross-sectional survey. Network analysis was used to analyze the symptom network and node characteristics, and factor analysis was used to examine symptom clusters. Results A total of 167 participants were included in this study. The participants included 111 men and 56 women with a mean age of 70.05 ± 7.40. The symptom burdens with the highest scores were dry skin, dry mouth, itching, and trouble staying asleep. Five symptom clusters were obtained from exploratory factor analysis, of which the clusters with the most severe symptom burdens were the gastrointestinal discomfort symptom cluster, sleep disorder symptom cluster, skin discomfort symptom cluster, and mood symptom cluster. Based on centrality markers, it could be seen that feeling nervous and trouble staying asleep had the highest strength, and feeling nervous and feeling irritable had the highest closeness and betweenness. Conclusions Hemodialysis patients have a severe symptom burden and multiple symptom clusters. Dry skin, itching, and dry mouth are sentinel symptoms in the network model; feeling nervous and trouble staying asleep are core symptoms of patients; feeling nervous and feeling irritable are bridge symptoms in this symptom network model. Clinical staff can formulate precise and efficient symptom management protocols for patients by using the synergistic effects of symptoms in the symptom clusters based on sentinel symptoms, core symptoms, and bridge symptoms. |
| first_indexed | 2024-04-09T15:11:56Z |
| format | Article |
| id | doaj.art-86b58e6f96fb4a169bca5cc8b0b7d264 |
| institution | Directory Open Access Journal |
| issn | 1471-2369 |
| language | English |
| last_indexed | 2024-04-09T15:11:56Z |
| publishDate | 2023-04-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Nephrology |
| spelling | doaj.art-86b58e6f96fb4a169bca5cc8b0b7d2642023-04-30T11:10:05ZengBMCBMC Nephrology1471-23692023-04-0124111410.1186/s12882-023-03176-4Exploration of symptom clusters during hemodialysis and symptom network analysis of older maintenance hemodialysis patients: a cross-sectional studyMingyao Zhou0Xiaoxin Gu1Kangyao Cheng2Yin Wang3Nina Zhang4School of Nursing, Shanghai University of Traditional Chinese MedicineSchool of Nursing, Shanghai University of Traditional Chinese MedicineSchool of Nursing, Shanghai University of Traditional Chinese MedicineSchool of Nursing, Shanghai University of Traditional Chinese MedicineHemodialysis Room, Shanghai Sixth People’s Hospital, Shanghai Jiaotong UniversityAbstract Background Symptom networks can provide empirical evidence for the development of personalized and precise symptom management strategies. However, few studies have established networks of symptoms experienced by older patients on maintenance hemodialysis. Our goal was to examine the type of symptom clusters of older maintenance hemodialysis patients during dialysis and construct a symptom network to understand the symptom characteristics of this population. Methods The modified Dialysis Symptom Index was used for a cross-sectional survey. Network analysis was used to analyze the symptom network and node characteristics, and factor analysis was used to examine symptom clusters. Results A total of 167 participants were included in this study. The participants included 111 men and 56 women with a mean age of 70.05 ± 7.40. The symptom burdens with the highest scores were dry skin, dry mouth, itching, and trouble staying asleep. Five symptom clusters were obtained from exploratory factor analysis, of which the clusters with the most severe symptom burdens were the gastrointestinal discomfort symptom cluster, sleep disorder symptom cluster, skin discomfort symptom cluster, and mood symptom cluster. Based on centrality markers, it could be seen that feeling nervous and trouble staying asleep had the highest strength, and feeling nervous and feeling irritable had the highest closeness and betweenness. Conclusions Hemodialysis patients have a severe symptom burden and multiple symptom clusters. Dry skin, itching, and dry mouth are sentinel symptoms in the network model; feeling nervous and trouble staying asleep are core symptoms of patients; feeling nervous and feeling irritable are bridge symptoms in this symptom network model. Clinical staff can formulate precise and efficient symptom management protocols for patients by using the synergistic effects of symptoms in the symptom clusters based on sentinel symptoms, core symptoms, and bridge symptoms.https://doi.org/10.1186/s12882-023-03176-4Maintenance hemodialysis in older patientsSymptom burdenSymptom clusterSymptom networkCore symptomsInfluencing factors |
| spellingShingle | Mingyao Zhou Xiaoxin Gu Kangyao Cheng Yin Wang Nina Zhang Exploration of symptom clusters during hemodialysis and symptom network analysis of older maintenance hemodialysis patients: a cross-sectional study BMC Nephrology Maintenance hemodialysis in older patients Symptom burden Symptom cluster Symptom network Core symptoms Influencing factors |
| title | Exploration of symptom clusters during hemodialysis and symptom network analysis of older maintenance hemodialysis patients: a cross-sectional study |
| title_full | Exploration of symptom clusters during hemodialysis and symptom network analysis of older maintenance hemodialysis patients: a cross-sectional study |
| title_fullStr | Exploration of symptom clusters during hemodialysis and symptom network analysis of older maintenance hemodialysis patients: a cross-sectional study |
| title_full_unstemmed | Exploration of symptom clusters during hemodialysis and symptom network analysis of older maintenance hemodialysis patients: a cross-sectional study |
| title_short | Exploration of symptom clusters during hemodialysis and symptom network analysis of older maintenance hemodialysis patients: a cross-sectional study |
| title_sort | exploration of symptom clusters during hemodialysis and symptom network analysis of older maintenance hemodialysis patients a cross sectional study |
| topic | Maintenance hemodialysis in older patients Symptom burden Symptom cluster Symptom network Core symptoms Influencing factors |
| url | https://doi.org/10.1186/s12882-023-03176-4 |
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