Enhancing Patient-Centered Communication in Hemodialysis Symptom Management Care-Development and Validation of the
1Department of Public Service, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning, China, cmu.edu.cn.
Insights
A new scale assesses help-seeking behavior (HSB) in hemodialysis patients, crucial for managing symptoms and improving quality of life. This tool aids healthcare providers in identifying patients needing targeted interventions for better care.
Area of Science:
- Nephrology
- Patient Care
- Health Psychology
Background:
- Chronic kidney disease (CKD) poses a global health challenge, with hemodialysis being a primary treatment for end-stage renal disease.
- Hemodialysis patients experience significant symptom burden, impacting their quality of life.
- Understanding timely help-seeking behavior (HSB) and its barriers is vital for effective symptom management, yet assessment tools are lacking.
Purpose of the Study:
- To develop and validate a scale measuring help-seeking behavior for symptoms in hemodialysis patients (HSB-HD).
- To provide a patient-centered tool for assessing HSB in this population.
- To facilitate identification of patients requiring tailored interventions for improved symptom management.
Main Methods:
- A multiphase, cross-sectional study involving 425 participants across three hospitals in China.
- Development of the HSB-HD scale through literature reviews, expert consultations, and patient interviews.
- Psychometric evaluation using classical test theory (CTT) and item response theory (IRT), assessing reliability, validity, and measurement invariance.
Main Results:
- Exploratory factor analysis identified a four-factor structure for HSB-HD, explaining 72.9% of variance.
- Confirmatory factor analysis demonstrated a good model fit.
- The scale exhibited excellent internal consistency (Cronbach's α = 0.953) and confirmed validity through correlations with quality of life measures.
Conclusions:
- The HSB-HD scale is a reliable and valid instrument for assessing help-seeking behavior in hemodialysis patients.
- This patient-centered tool empowers healthcare providers to identify individuals who may benefit from specific interventions.
- Implementation of the HSB-HD scale can enhance symptom management, leading to improved patient care and quality of life.
Background:
Chronic kidney disease (CKD) is a global health challenge, and hemodialysis is a common treatment for end-stage renal disease. Patients undergoing hemodialysis often face significant symptom burden, affecting their quality of life. Timely help-seeking behavior (HSB) is crucial for initiating patient-centered communication and effective symptom management. Yet, the specific behavioral patterns and barriers to help-seeking in this group remain poorly understood. However, tools to assess HSB in this population are lacking.
Methods:
This multiphase cross-sectional study was conducted across three hospitals in China from August to October 2024, involving 425 participants. The study developed the HSB for hemodialysis symptoms (HSB-HD) scale based on literature reviews, expert consultations, and patient interviews. Psychometric evaluation was performed using classical test theory (CTT) and item response theory (IRT), focusing on reliability, validity (content, construct, criterion-related, discriminant, and convergent), and measurement invariance.
Results:
The exploratory factor analysis (EFA) revealed a four-factor structure (symptom detection, symptom interpretation, decision-making for help-seeking, and timely disclosure and action), explaining 72.9% of variance. Confirmatory factor analysis (CFA) showed a good model fit (CFI = 0.964, RMSEA = 0.045). Cronbach's α was 0.953, indicating excellent internal consistency. Validity tests showed significant correlations with the EQ-5D-5L pain, anxiety, and VAS scores. Measurement invariance was confirmed across gender and age groups.
Conclusions:
The HSB-HD scale is a reliable and valid tool for assessing HSB in hemodialysis patients. It offers a patient-centered approach to symptom management, providing health care providers with a means to identify those who may benefit from targeted interventions, thereby improving care and quality of life.
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