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Multidimensional symptom clusters: an exploratory factor analysis in advanced chronic kidney disease
Hayfa Almutary1,2,3, Clint Douglas1, Ann Bonner1,3,4
1School of Nursing, Queensland University of Technology, Brisbane, Queensland, Australia.
Journal of Advanced Nursing
|May 21, 2016
Summary
Researchers identified five distinct symptom clusters in advanced chronic kidney disease patients, including fluid volume, neuromuscular, gastrointestinal, sexual, and psychological symptoms. This finding aids in better symptom management for kidney disease patients.
Area of Science:
- Nephrology
- Symptom Science
- Patient Care
Background:
- Patients with chronic kidney disease (CKD) frequently experience multiple symptoms.
- The intricate connections between these symptoms in advanced CKD are not well understood.
Purpose of the Study:
- To investigate the existence and nature of symptom clusters in individuals with advanced chronic kidney disease (CKD).
Main Methods:
- A cross-sectional study involving 436 participants with stage 4 and 5 CKD.
- Utilized the Chronic Kidney Disease-Symptom Burden Index to assess 32 symptoms across four dimensions.
- Employed exploratory factor analysis to identify symptom clusters within each dimension.
Main Results:
- Consistently identified five symptom clusters: fluid volume, neuromuscular, gastrointestinal, sexual, and psychological symptoms.
- Symptoms like fatigue, sleep disturbance, and restless legs were interconnected across multiple clusters.
- Fatigue was identified as a pervasive symptom, cross-loading on all five identified clusters.
Conclusions:
- A symptom cluster approach can significantly improve symptom assessment and nursing care for advanced CKD patients.
- Targeted management strategies at the cluster level may reduce overall symptom burden and fatigue.
- Routine clinical assessment should incorporate cluster-based approaches for enhanced patient outcomes.
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