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An analysis of the latent classification and influencing factors of the characteristic symptoms in patients with maintenance hemodialysis

Published on Aug. 31, 2024Total Views: 929 timesTotal Downloads: 286 timesDownloadMobile

Author: FENG Meiqin 1 CHEN Hongfang 2 ZHANG Jiayang 1 ZHANG Layin 1

Affiliation: 1. School of Nursing, Shaanxi University of Traditional Chinese Medicine, Xianyang 712000, Shaanxi Province, China 2. Department of General Affairs, Shaanxi Provincial Hospital of Chinese Medicine, Xi’an 710000, China

Keywords: Maintenance hemodialysis Symptom Latent profile analysis Influencing factor

DOI: 10.12173/j.issn.1004-5511.202407016

Reference: Feng MQ, Chen HF, Zhang JY, Zhang LY. An analysis of the latent classification and influencing factors of the characteristic symptoms in patients with maintenance hemodialysis[J]. Yixue Xinzhi Zazhi, 2024, 34(8): 906-915. DOI: 10.12173/j.issn.1004-5511.202407016. [Article in Chinese]

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Abstract

Objective  To explore the potential subgroups of symptom characteristics and their influencing factors in maintenance hemodialysis (MHD) patients.

Methods Patients with MHD in the hemodialysis department of Shaanxi Provincial Hospital of Chinese Medicine from November 2023 to April 2024 were selected by convenience sampling method, and survyed with the general data questionnaire and Dialysis Symptom Index. Mplus 8.3 was used for latent profile analysis of group symptoms, and binary Logistic regression was used to analyze the influencing factors of symptoms group.

Results  A total of 211 cases of MHD patients were included and divided into two groups: low symptom burden group (39%) and high symptom burden group (61%) according to their symptom characteristics. The results of regression analysis showed that gender[OR=0.189, 95%CI(0.080, 0.446)], age[OR=1.085, 95%CI(1.048, 1.124)]and serum sodium [OR=0.862, 95%CI(0.774, 0.959)]were the influencing factors that distinguished the two subgroups (P ﹤0.05).

Conclusion  There is heterogeneity in the symptom characteristics of MHD patients, which can be divided into two potential subgroups. Medical staff should pay more attention to female patients, elderly patients, and patients with serum sodium levels less than 138.46 mmol/L.

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1.《中国围透析期慢性肾脏病管理规范》专家组. 中国围透析期慢性肾脏病管理规范[J]. 中华肾脏病杂志, 2021, 37(8): 690-704. [Experts Group of China Guideline for the Management of Peri-dialysis Chronic Kidney Disease. Chinese peridialysis chronic kidney disease management standards[J]. Chinese Journal of Nephrology, 2021, 37(8): 690-704.] DOI: 10.3760/cma.j.cn441217-20210322-00104.

2.吴佳杰, 熊贝妮, 李贤华. 维持性血液透析患者生活质量的现状及其影响因素[J]. 解放军护理杂志, 2014, 31(2): 6-10. [Wu JJ, Xiong BN, Li XH. Current status and influencing factors of quality of life in patients on maintenance hemodialysis[J]. PLA Journal of Nursing, 2014, 31(2): 6-10.] DOI: 10.3969/j.issn.1008-9993. 2014.02.002.

3.Foreman KJ, Marquez N, Dolgert A, et al. Forecasting life expectancy, years of life lost, and all-cause and cause-specific mortality for 250 causes of death: reference and alternative scenarios for 2016-40 for 195 countries and territories[J]. Lancet, 2018, 392(10159): 2052-2090. DOI: 10.1016/S0140-6736(18)31694-5.

4.Canaud B, Köhler K, Sichart JM, et al. Global prevalent use, trends and practices in haemodiafiltration[J]. Nephrol Dial Transplant, 2020, 35(3): 398-407. DOI: 10.1093/ndt/gfz005.

5.罗英, 李洁, 袁怀红. 维持性血液透析患者认知衰弱的研究进展[J]. 华西医学, 2024, 39(7): 1131-1136. [Luo Y, Li J, Yuan  HH. Research progress on cognitive weakness in patients on maintenance hemodialysis[J]. HuaXi Medicine, 2024, 39(7): 1131-1136.] DOI: 10.7507/1002-0179.202406179.

6.曹晓翼, 张颖君, 石梅, 等. 血液透析患者症状负担的影响因素研究[J]. 护理学杂志, 2017, 32(5): 17-20. [Cao XY, Zhang YJ, Shi M, et al. Associated factors of symptom burden among patients undergoing hemodialysis[J]. Journal of Nursing Science, 2017, 32(5): 17-20.] DOI: 10.3870/j.issn.1001-4152.2017.05.017.

7.Jablonski A. The multidimensional characteristics of symptoms reported by patients on hemodialysis[J]. Nephrol Nurs J, 2007, 34(1): 29 -38. https://pubmed.ncbi.nlm.nih.gov/17345690/

8.Horigan AE, Schneider SM, Docherty S, et al. The experience and self - management of fatigue in patients on hemodialysis[J]. Nephrol Nurs J, 2013, 40(2): 113-123. https://pubmed.ncbi.nlm.nih.gov/23767335/

9.Miaskowski C, Barsevick A, Berger A, et al. Advancing symptom science through symptom cluster research: expert panel proceedings and recommendations[J]. J Natl Cancer Inst, 2017, 109(4): djw253. DOI: 10.1093/jnci/djw253.

10.温忠麟, 谢晋艳, 王惠惠. 潜在类别模型的原理、步骤及程序[J]. 华东师范大学学报: 教育科学版, 2023, 41(1): 1-15. [Wen ZL, Xie JY, Wang HH. The principles, steps, and procedures of latent class models[J]. Journal of East China Normal University: Educational Science Edition, 2023, 41(1): 1-15.] DOI: 10.16382/j.cnki.1000-5560. 2023.01.001.

11.陈玉珍, 郑剑煌, 姜志钊, 等. 脓毒症后综合征患者症状特征的潜在类别分析[J]. 中华急危重症护理杂志, 2024, 5(3): 197-204. [Chen YZ, Zheng JH, Jiang ZZ, et al. Latent class analysis of symptom characteristics in patients with post-sepsis syndrome[J]. Chinese Journal of Acute and Critical Care Nursing, 2024, 5(3): 197-204.] DOI: 10.3761/j.issn.2096-7446.2024.03.001.

12.张淑华, 蒋萍梅, 蔡晓兰, 等. 肝硬化症状特征的潜在类别分析和影响因素[J]. 肝脏, 2024, 29(3): 273-277. [Zhang SH, Jiang PM, Cai XL, et al. Potential category analysis and influencing factors of the symptomatic characteristics of cirrhosis[J]. Liver, 2024, 29(3): 273-277.] DOI: 10.14000/j.cnki.issn.1008-1704.2024.03.007.

13.黄悦勤. 医学科研中随机误差控制和样本量确定[J]. 中国心理卫生杂志, 2015, 29(11): 874-880. [Huang YQ. Random error control and sample size determination in medical research[J]. Chinese Mental Health Journal, 2015, 29(11): 874-880.] DOI: 10.3969/j.issn.1000-6729.2015. 11.014.

14.Hays RD, Kallich JD, Mapes DL, et al. Development ofthe kidney disease qualityof life (KDQOL) instrument[J]. Qual Life Res, 1994, 3(5): 329-338. DOI: 10.1007/BF00451725.

15.郝艳华. 血液透析患者症状的相关研究[D]. 北京:北京协和医学院, 2016. [Hao YH. Studies on symptoms in hemodialysis patients[D]. Beijing: Peking Union Medical College, 2016.] DOI: 10.7666/d.Y3075706.

16.Weisbord SD, Fried LF, Arnold RM, et al. Development of a symptom assessment instrument for chronic hemodialysis patients: the Dialysis Symptom Index[J]. J Pain Symptom Manage, 2004, 27(3): 226-240. DOI: 10.1016/j.jpainsymman.2003.07.004.

17.翟林君, 刘蓉, 郭傲寒, 等. 维持性血液透析患者的症状群及网络分析[J]. 护士进修杂志, 2023, 38(24): 2289-2294, 2302. [Zhai LJ, Liu R, Guo AH, et al. Symptom clusters and network analysis in maintenance hemodialysis patients[J]. Journal of Nurses Training, 2023, 38(24): 2289-2294, 2302.] DOI: 10.16821/j.cnki.hsjx.2023.24.015.

18.刘正翠, 游励红, 肖红波, 等. 维持性血液透析患者症状群的确立及其与生活质量的相关性研究[J]. 中国血液净化, 2018, 17(11): 748-752. [Liu ZC, You LH, Xiao Hb, et al. Establishment of symptom group in maintenance hemodialysis patients and its correlation with qualityof life[J]. Chinese Journal of Blood Purification, 2018, 17(11): 748-752.] DOI: 10.3969/j.issn.1671-4091.2018.11.007.

19.Yu IC, Huang JY, Tsai YF. Symptom cluster among hemodi-alysis patients in Taiwan[J]. Appl Nurs Res, 2012, 25(3): 190-196. DOI: 10.1016/j.apnr.2010.11.002.

20.Zhou M, Gu X, Cheng K, et al. Exploration of symptom clusters during hemodialysis and symptom network analysis of older maintenance hemodialysis patients: a cross-sectional study[J/OL]. BMC Nephrol, 2023, 24(1): 115. DOI: 10.1186/s12882-023-03176-4.

21.孙欣. 血液透析患者生命意义感在症状群及生活质量的中介作用[D]. 济南:山东大学, 2021. [Sun X. The mediating role of hemodialysis patients' sense of meaning in life in symptom clusters and quality of life[D]. Jinan: Shandong University, 2021.] https://d.wanfangdata.com.cn/thesis/ChJUaGVzaXNOZXdTMjAyNDAxMDkSCFkzODE3NDM0Ggh4bWJ5eXBoYg%3D%3D.

22.Arghide Y, Faraji A, Raygani AAV, et al. The effect of hemodialysis with cool dialysate on nausea in hemodialysis patients: A randomized clinical trial[J]. Health Sci Rep, 2023, 6(11): e1709. DOI: 10.1002/hsr2.1709.

23.吴叶艳, 金晓敏, 全碧泉. 艾灸联合穴位贴敷对血液透析患者消化道症状、水肿程度及生活质量的影响[J]. 上海针灸杂志, 2022, 41(9): 873-877. [Wu YY, Jin XM, Jin BQ. Effects of moxibustion combined with acupoint sticking therapy on the gastrointestinal symptoms, swelling severity, and quality of life in hemodialysis patients[J]. Shanghai Journal of Acupuncture and Moxibustion, 2022, 41(9): 873-877.] DOI: 10.13460/j.issn.1005-0957. 2022.09.0873.

24.强婷. 尿毒症患者应用血液透析联合血液灌流治疗皮肤瘙痒的疗效观察[J]. 心理医生, 2018, 24(1): 52-53. [Qiang T. The efficacy of hemodialysis combined with hemoperfusion in the treatment of skin itching in uremia patients was observed[J]. Psychiatrist, 2018, 24(1): 52-53.] https://d.wanfangdata.com.cn/periodical/xlys-x201801039.

25.尤朝香, 贾梦滢, 李霜, 等. 直肠癌患者经腹腔镜保肛术后的症状群轨迹及影响因素研究[J]. 中华护理杂志, 2024, 59(8): 922-929. [You ZX, Jia MY, Li X, et al. Study on the trajectories of symptom groups and influencing factors in patients with rectal cancer after laparoscopic anus-preserving surgery[J]. Chinese Journal of Nursing, 2024, 59(8): 922-929.] DOI: 10.3761/j.issn.0254-1769. 2024.08.004.

26.周肖侠, 高百花, 王梅娟, 等. 老年心力衰竭患者出院过渡期症状群变化及其影响因素分析[J]. 中华保健医学杂志, 2023, 25(5): 581-583. [Zhou XX, Gao BH, Wang MJ, et al. Changes of symptom clusters and influencing factors in elderly patients with heart failure during the transition period of hospital discharge[J]. Chinese Journal of Health Care and Medicine, 2023, 25(5): 581-583.] DOI: 10.3969/j.issn.1674-3245.2023.05.024.

27.罗曦, 唐姗姗. 脑卒中患者症状负担、日常感知歧视现状及其影响因素[J]. 中国社会医学杂志, 2024, 41(2): 185-190. [Luo X, Tang SS. Symptom burden, current status and influencing factors of daily perceived discrimination in stroke patients[J]. Chinese Journal of Social Medicine, 2024, 41(2): 185-190.] DOI: 10.3969/j.issn.1673-5625.2024.02.013.

28.刘丹, 徐佳美, 翁宁, 等. 腹膜透析患者症状群特征及其影响因素分析[J]. 中国中西医结合肾病杂志, 2024, 25(3): 224-228. [Liu D, Xu JM, Weng N, et al. Characteristics of symptom clusters and their influencing factors in peritoneal dialysis patients[J]. Chinese Journal of Integrative Medicine Nephrology, 2024, 25(3): 224-228.] DOI: 10.3969/j.issn.1009-587X.2024.03.011.

29.朱大年, 王庭槐. 《生理学》第9版[M]. 北京: 人民卫生出版社, 2018. [Zhu DN, Wang TH. Physiology 9th edition[M]. Beijing: People's Health Publishing House, 2018.]

30.王建枝, 钱睿哲. 《病理生理学》第9版[M]. 北京: 人民卫生出版社, 2018. [Wang JZ, Qian RZ. Pathophysiology 9th edition[M]. Beijing: People's Health Publishing House, 2018.]

31.中华医学会内分泌学分会电解质紊乱学组. 低钠血症的中国专家共识[J]. 中华内分泌代谢杂志, 2023, 39(12): 999-1009. [Electrolyte Disorders Group, Endocrinology Branch, Chinese Medical Association. Chinese expert consensus on hyponatremia[J]. Chinese Journal of Endocrinology and Metabolism, 2023, 39(12): 999-1009.] DOI: 10.3760/cma.j.cn311282-20230526-00236.

32.聂丽敏, 闫康, 张国欣, 等. 不同血液净化方式对中分子及小分子物质的清除效果研究[J]. 医学研究杂志, 2017, 46(3): 162-167. [Nie LM, Yan K, Zhang GX, et al. Study on the scavenging effect of different blood purification methods on medium and small molecule substances[J]. Journal of Medical Research, 2017, 46(3): 162-167.] DOI: 10.11969/j.issn.1673-548X.2017.03.040.

33.彭源, 朱林芳, 高梦琳, 等. 维持性血液透析患者的营养素养现状及影响因素分析[J].华西医学, 2023, 38(7): 1021-1026. [Peng Y, Zhu LF, Gao ML, et al. Current status and influencing factors of nutritional literacy in maintenance hemodialysis patients[J]. HuaXi Medicine, 2023, 38(7): 1021-1026.] https://www.cnki.com.cn/Article/CJFDTOTAL-HXYX202307010.htm.