การจัดการอาการของผู้ที่เป็นโรคไตเรื้อรังระยะสุดท้ายที่ได้รับการล้างไตทางช่องท้องอย่างต่อเนื่อง

Dekyong E; Srirat C; Tachaudomdach Chiraporn

Authors

Dekyong E Faculty of Nursing, Chiang Mai University, Chiang Mai, Thailand
Srirat C Faculty of Nursing, Chiang Mai University, Chiang Mai, Thailand
Tachaudomdach Chiraporn Faculty of Nursing, Chiang Mai University, Thailand

Keywords:

symptom management, persons with end - stage renal disease, continuous ambulatory peritoneal dialysis

Abstract

Objectives The objective of this study was to categorize the symptoms and methods of symptom management of people with end-stage renal disease (ESRD) receiving continuous ambulatory peritoneal dialysis (CAPD).

Methods This descriptive research study purposively sampled 293 ESRD patients receiving CAPD in four hospitals. Research instruments included 1) a general data record form, 2) an interview form for assessment of the CKD Symptom Burden Index (CKD-SBI), and 3) a symptoms management
interview form for ESRD patients receiving CAPD. Data were analyzed using descriptive statistics.

Results Itching was the most frequently reported symptom (67.23%), with mean frequency, severity, and distress scores of “X” x ± SD of 4.51 ± 1.62, 4.59 ± 1.34, and 5.53 ± 1.70, respectively. The participants used a variety of methods to manage each of the five main symptoms including: 1) applying cream or lotion for itching (84.80%), 2) general touching/squeezing for bone or joint pain (86.70%), 3) relaxing in a sitting position or lying down for muscle soreness (90.30%), 4) foot stretching and contraction plus ankle flexing for muscle cramps (77.10%), and 5) relaxing or resting in a sitting position or lying down for headaches (94.50%).

Conclusions The results of this research provide basic information for nurses and health care personnel to use in assessing patients’ symptom experience and can help guide for the planning of care as well as recommending or promoting symptom management for people with end-stage renal disease who are receiving continuous ambulatory peritoneal dialysis. Development of a symptom management model for people with end-stage renal diseases receiving continuous ambulatory peritoneal dialysis is recommended.

References

Thai Health Promotion Foundation. Thai with kidney disease ranked 3rd in ASEAN. [Internet]. [cited 2018 January 3]. Available from: http://www.thaihealth.or.th/Content/30963.html. (in Thai).

Ministry of Public Health. Kidney disease support research and development of service systems. [Internet]. [cited 2018 January 8]. Available from: https://www.whfocus.org/ content/2016/09/12707. (In Thai).

Levin A, Stevens PE, Bilous RW, Coresh J, De Francisco ALM, De Jong PE, et al. Kidney disease Improving global outcomes (KDIGO) CKD work group. KDIGO 2012 clinical practice guideline for the evaluation and management of chronic kidney disease. Kidney Int. 2013;3:1-150.

Brener ZZ, Thijssen S, Kotanko P, Kuhlmann MK, Bergman M, Winchester JF, Levin NW. The impact of residual renal function on hospitalization and mortality in incident hemodialysis patients. Blood Purif. 2011;31:243-51.

Kadeelok P. A study of symptom experience, and symptom management strategies among end stage renal disease patients receiving continuous ambulatory peritoneal dialysis. [Master’s Thesis, Faculty of Nursing]. Chulalongkorn University; 2017. (in Thai).

Pittayanarueman S. A comparative study of symptom clusters in patients with end stage renal disease in southern region, Thailand. [Master’s Thesis, Faculty of Nursing]. Chulalongkorn University; 2009. (in Thai).

Almutary H, Bonner A, Douglas C. Arabic translation, adaptation and modification of the dialysis symptom index for chronic kidney disease stages four and five. BMC Nephrol. 2015;16:36.

Sriyuktasuth A, Vongsirimas N, Prapaiwong P. Quality of life and related factors in women receiving hemodialysis and continuous ambulatory peritoneal dialysis: a comparative study. J Nurs Sci. 2017;35(1):72-84. (in Thai).

Kankarn W. PD first policy holistic nursing in CAPD patients: challenge role under PD first policy. Journal of Nursing and Health Care. 2016;33:6-14. (in Thai).

Dodd M, Janson S, Facione N, Faucett J, Froelicher ES, Humphreys J, et al. Advancing the science of symptom management. J Adv Nurs. 2001;33:668-76.

Almutary H, Bonner A, Douglas C. Which patients with chronic kidney disease have the greatest symptom burden? A comparative study of advanced CKD stage and dialysis modality. J Ren Care. 2016;42:73-82.

Zhan L. Quality of life: conceptual and measurement issues. J Adv Nurs. 1992;17:795-800.

Saengkot P. Study on risk factors relating to chronic kidney disease in persons who at risk to chronic kidney disease. [Master’s Thesis, Faculty of Nursing]. Khon Kaen University; 2011. (in Thai).

Chidnayee S. Nursing care of person chronic kidney disease receiving hemodialysis dialysis. Bangkok: Tana press: 2007. (in Thai).

Kidney Health Australia. Common Kidney Disease Symptoms and Management Options. [Internet]. [cited 2018 Feb 4]. Available from: https://kidney.org.au/uploads/resources/common-kidney-disease-symptoms-and-management-fact-sheet%E2%80%93-kidney-health-australia.pdf.

Joikla S. Symptoms, symptom evaluation and symptom management in chronic hemodialysis patients. [Master’s Thesis, Faculty of Nursing]. Burapha University; 2007. (in Thai).

Pham PC, Khaing K, Sievers TM, Pham PM, Miller JM, Pham SV, et al. 2017 update on pain management in patients with chronic kidney disease. Clin Kidney J. 2017;10:688-97.

Pangsri S, Panpakdee O, Phinitkhajorndech N. Factors predicting health-related quality of life in chronic kidney disease patients receiving dialysis in Chanthaburi province. J Nurs Ed. 2015;8:66-80. (in Thai).

Konkaew P, Suphunnakul P. Risk behaviors of chronic kidney disease: perspectives of patients with chronic kidney disease. Thai Journal of Public Health. 2019;49:313-24. (in Thai).

Krejcie RV, Morgan DW. Determining sample size for research activities. Educ Psychol Meas 1970;30:607-10.

Hemrungrojn, S. MoCA Thai Version. [Internet]. [Cited 2018 May 4]. Available from: https://www.mocatest.org/wp-content/uploads/2015/tests-instructions/MoCA-Test Thai.pdf. (in Thai).

Li J, Guo Q, Lin J, Yi C, Yang X, Yu X. revalence and associated factors of uraemic pruritus in continuous ambulatory peritoneal dialysis patients. Intern Med. 2015;54:2827-33.

Post JB, Jegede AB, Morin K, Spungen AM, Langhoff E, Sano M. Cognitive profile of chronic kidney disease and hemodialysis patients without dementia. Nephron Clin Pract. 2010;116:c247-55.

Bargman J. M. Home peritoneal dialysis unit patient manual. 11th ed. [Internet]. [cited 2020 July 11]. Available from: https://www.uhn.ca/MCC/Clinics/Home_Peritoneal_Dialysis/Documents/ Home Peritoneal Dialysis_manual.pdf.

Chomchuen C. Effects of spouse support on protein consumption behavior, blood urea nitrogen and creatinine of chronic kidney disease patients. [Master’s Thesis, Faculty of Nursing]. Burapha University; 2013. (in Thai)

Gorji MH, Davanloo AA, Heidarigorji AM. The efficacy of relaxation training on stress, anxiety, and pain perception in hemodialysis patients. Indian J Nephrol. 2014;24:356-61.