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Sex differences in symptom severity and clusters in patients with stage C4 and stage C5 chronic venous disease
Teresa J Kelechi1, Martina Mueller1, Mary Dooley1
1Medical University of South Carolina, College of Nursing, Charleston, SC, USA.
Background:
Multiple symptoms associated with chronic venous disease (CVD) are poorly understood, under-recognized, and ill-managed.
Aims:
The aim of this study was to determine whether there are differences in symptoms and symptom clusters between men and women with stage C4 and stage C5 CVD.
Methods:
Data were collected via interviews with 264 patients using a demographic survey and an 11-item VEINES-SYM questionnaire.
Analysis:
An intrinsic scoring algorithm was developed to calculate the overall t scores for each item by sex. Exploratory factor analysis identified symptom clusters using oblique rotation to account for correlations between factors.
Results:
The average age was 61.7 years; 54.5% of the patients were women, 58% were African American or black, and 60.6% had diabetes. The top three symptoms for women in order of frequency were achy legs, swelling, and pain; for men, these were swelling, achy legs, and heavy legs. For the total group, two symptom clusters emerged: distressful and discomfort. There was no statistically significant difference in factor score between the sexes. Different factor loadings for symptom clusters were observed: women reported hurting and annoying clusters; and men reported nagging and irritating clusters.
Conclusion:
The data suggest differences in CVD symptoms and clusters by sex. Symptoms in the two clusters were different; however, there was consistency in the factors associated with each cluster. Co-morbid conditions and sex differences in pain responses may play a part in symptom presentation. This study supports the need for increased sex-delineated clinical assessment and consideration of the potential differences between the sexes in the management of CVD symptoms.
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