Symptom Burden and Health-Related Quality of Life among Patients Undergoing Hemodialysis in China
Keywords:
symptoms burden, health-related quality of life, hemodialysis, end-stage renal diseaseAbstract
OBJECTIVE This descriptive correlational study aimed to identify the top three contributors to symptom burden and health-related quality of life (HRQOL) and to examine the relationship between the top three symptom burdens and HRQOL among patients undergoing hemodialysis (HD) in the People’s Republic of China.
METHODS Purposive sampling of 142 patients from 2 hospitals receiving HD was done. Instruments included demographic data form, Dialysis Frequency Severity, Symptom Burden Index, and Kidney Disease Quality of Life-36. Data were analyzed using descriptive statistics and Spearman rank-order.
RESULTS The top three symptom burden items were feeling tired, itching, and having trouble staying asleep. The mean scores were 8.80 ± 2.67, 6.42 ± 3.17, and 5.94 ± 4.20, respectively. The mean score for five subscales of HRQOL were symptoms/problems with kidney disease 77.27 (SD = 10.37), impact of kidney disease 59.62 (SD = 11.18), burden of kidney disease 15.67 (SD = 15.29), physical component summary 30.15 (SD = 5.98), and mental component summary 40.29 (SD = 7.91). There was a negative relationship among the top three symptom burdens and HRQOL (rs = -0.26 -0.52, p < 0.01).
CONCLUSIONS The findings provide clinical nurses in China with information to develop more effective symptom management strategies which may help improve patients’ HRQOL.
References
Jacobson J, Ju A, Baumgart A, Unruh M, Odono-ghue D, Obrador GT, et al. Patient perspectives on the meaning and impact of fatigue in hemodialy-sis: A systematic review and thematic analysis of qualitative studies. Am J Kidney Dis. 2019;74:179-92.
Li H, Xie L, Yang J, Pang X. Symptom burden amongst patients suffering from end-stage renal disease and receiving dialysis: a literature review. Int J Nurs Sciences. 2018;5:427-31.
Wu ZB, Han XW, Tan QZ, Pan Z K, Li J, Zhou HH, et al. Three hundred seventy-eight middle-aged and young patients with maintenance hemodialysis treatment compliance status and influencing fac-tors analysis. J Nurs. 2020;27:47-51. [In Chinese]
Delmas P, Cohen C, Loiselle M C, Antonini M, Pas-quier J, Burnier M. Symptoms and quality of life from patients undergoing hemodialysis in Swit-zerland. Clin Nurs Stud. 2018;6:63-72.
Davison SN, Jhangri GS. Impact of pain and symp-tom burden on the health-related quality of life of hemodialysis patients. J Pain and Symptom Manage. 2010;39:477-85.
Danquah FV, Zimmerman I, Diamond PM, Mei-ninger J, Bergstrom N. Frequency, severity, and distress of dialysis-Related symptom reported by patients on hemodialysis. Nephrol Nurs J. 2010; 37:627-38.
Liu ZC, You LH, Xiao HB, Zou SX, Chen GM, Jiang L. Establishment of symptom clusters in mainte-nance hemodialysis patients and their correlation with quality of life. Chin Blood Purif. 2018;17:748-52. [In Chinese]
Centers for Disease Control and Prevention. (2000). measuring healthy days: population as-sessment of health-related quality of life [inter-net]. [cite 2021 June 31]. Available from: https://www.cdc.gov/hrqol/pdfs/mhd. pdf
Ju A, Unruh ML, Davison SN, Dapueto J, Dew MA, Fluck R, et al. Patient-reported outcome measures for fatigue in patients on hemodialysis: a system-atic review. Am J Kidney Dis. 2018;71:327-43.
Bossola M, DiStasio E, Marzetti E, DeLorenzis K, Pepe G, Vulpio C. Fatigue is associated with high prevalence and severity of physical and emotion-al symptoms in patients on chronic hemodialysis. Int Urol Nephrol. 2018;50:1341-6.
Horigan AE. Fatigue in hemodialysis patients: A review of current knowledge. J Pain Symptom Manage. 2012;44:715-24.
Theofilou, P. Association of insomnia symptoms with kidney disease quality of life reported by pa-tients on maintenance dialysis. Psychol Health Med. 2013;18:70-8.
Roth T. Insomnia: definition, prevalence, etiology, and consequences. J Clin Sleep Med. 2007;3(5 Sup-pl):S7-10.
Pai MF, Hsu SP, Yang SY, Ho TI, Lai CF, Peng YS. Sleep disturbance in chronic hemodialysis pa-tients: the impact of depression and anemia. Ren Fail. 2007;29:673-7.
Ramakrishnan K, Bond TC, Claxton A, Sood VC, Kootsikas M, Agnese W, et al. Clinical characteris-tics and outcomes of end-stage renal disease pa-tients with self-reported pruritus symptoms. Int J Nephrol Renovasc Dis. 2013;7:1-12.
Ersoy NA, Akyar İ. Multidimensional pruritus as-sessment in hemodialysis patients. BMC Nephrol. 2019;20:42.
Mollanazar NK, Koch SD, Yosipovitch G. Epidemi-ology of chronic pruritus: where have we been and where are we going? Curr Dermatol Rep. 2015;4: 20-9.
Raj R, Ahuja KD, Frandsen M, Jose M. Symptoms and their recognition in adult haemodialysis pa-tients: interactions with quality of life. Nephrol. 2017;22:228-33.
Xu WN, Weng JJ, Jiang LY. Correlation analysis between symptom burden and quality of life in maintenance hemodialysis patients. Health Res. 2019;39:25-28. [In Chinese]
Zhou XJ, Zhao QH, Liu L. Correlation between symptom group and symptom burden and qual-ity of life in maintenance hemodialysis patients. Chongqing: Chongqing Med Univ. 2013. [in Chi-nese]
Yu HD, Petrini MA. The HRQOL of Chinese patients undergoing haemodialysis. J Clin Nurs. 2010;19: 658-65.
Chen JY, Wan EY, Choi EP, Chan AK, Chan KH, Tsang JP, et al. The health-related quality of life of Chinese patients on hemodialysis and peritoneal dialysis. Patient. 2017; 10:799-808.
Nasreddine ZS, Phillips NA, Bédirian V, Charbon-neau S, Whitehead V, Collin I, et al. The Montreal Cognitive Assessment, MoCA: a brief screening tool for mild cognitive impairment. J Am Geriatr Soc. 2005;53:695-9.
Grove SK, Burns N, Gray JR. The practice of nursing research: Appraisal, synthesis and generation of evidence. 7th ed. St. Louis: Saunders, Elsevier; 2013.
Li CY. Analysis of the content and approach of school sex education. Chin Sexual Sciences. 2020; 29:150-3. [In Chinese]
Chang LL,Yang SL, Zhang XS, Wu WB. Clinical study of sexual dysfunction in hemodialysis pa-tients. Chin J Integrated Traditional Chin and West Med Nephrop. 2014;15:232-3. [In Chinese]
Ma H, Lu JH, Wei DL, Ma HW. Research progress of sexual life status of long-term dialysis patients and health education countermeasures. Tianjin J Nurs. 2010; 29:735. [In Chinese]
Cohen DE, Lee A, Sibbel S, Benner D, Brunelli SM, Tentori F. Use of the KDQOL-36™ for assessment of health-related quality of life among dialysis patients in the United States. BMC Nephrol. 2019; 20:112.
Goh KK, Lai PS, Lim SK. Cross cultural adaptation and validation of the Malay Kidney Disease Quality of Life (KDQOL-36™). BMC Nephrol. 2019; 20:1-9.
Pan CW, Wu Y, Zhou HJ, Xu BX, Wang P. Health-re-lated quality of life and its factors of hemodialysis patients in Suzhou, China. Blood Purif. 2018;45: 327-33.
Wassef OM, El-Gendy MF, El-Anwar RM, El-Taher SM, Hani BM. Assessment of health-related qual-ity of life of hemodialysis patients in Benha City, Qalyubia Governorate. Menoufia Med J. 2018;31: 1414.
Higuitagutierrez LF, Velascocastano JJ, Quiceno JN. Health-related quality of life in patients with chronic kidney disease in hemodialysis in Medellín (Colombia). Patient Prefer Adherence. 2019;13: 2061-70.
Cox KJ, Parshall MB, Hernandez SH, Parvez S, Un-ruh M. Symptoms among patients receiving in-center hemodialysis: A qualitative study. Hemodial Int. 2017; 21:524-33.
Mirghaed MT, Sepehrian R, Rakhshan A, Gorji H. Sleep quality in Iranian hemodialysis patients: A systematic review and meta-analysis. Iran J Nurs Midwifery Res. 2019;24:403-9.
DeSanto RM, Lucidi F, Violani C, Di Iorio BR. Sleep disorders in hemodialyzed patients-the role of comorbidities. Int J Artif Organs. 2005;28:557-65.
