Factors Associated with Symptom Burden in Adults with Chronic Kidney Disease Undergoing Hemodialysis: A Prospective Study.
Thalwaththe Gedara Nadeeka Shayamalie Gunarathne,1,2 Li Yoong Tang,1,* Soo Kun Lim,3 Nishantha Nanayakkara,4 Hewaratne Dassanayakege Wimala Thushari Damayanthi,2 and Khatijah L. Abdullah5
1 Department of Nursing Science, Faculty of Medicine, University Malaya, Kuala Lumpur 50603, Malaysia; [email protected] or [email protected]
2 Department of Nursing, Faculty of Allied Health Sciences, University of Peradeniya, Peradeniya 20400, Sri Lanka; [email protected]
3 Department of Medicine, Faculty of Medicine, University Malaya, Kuala Lumpur 50603, Malaysia; [email protected]
4 Nephrology and Dialysis Unit, National Hospital, Kandy 20000, Sri Lanka; [email protected]
5 Department of Nursing, School of Medical and Life Science, Sunway University, Bandar Sunway 47500, Malaysia; [email protected]
* Correspondence: [email protected]; Tel.: +603-7949-3646
People with end stage renal disease and undergoing hemodialysis experience a high symptom burden that impairs quality of life. This study aimed to assess the prevalence, dynamicity and determinants of symptom burden among middle-aged and older adult hemodialysis patients. A descriptive cross-sectional study together with a longitudinal assessment was used. A total of 118 and 102 hemodialysis patients were assessed at baseline and at a 6-month follow-up. Validated questionnaires were used to assess the symptom burden, stress, illness perception and social support. Multiple linear regression analysis was used to determine the factors associated with symptom burden. The median number of symptoms experienced was 21 (Interquartile Range (IQR); 18–23) and 19 (IQR; 13–22) at baseline and 6 months, respectively. Having elevated stress (β = 0.65, p ≤ 0.005) and illness perception (β = 0.21, p = 0.02) were significantly predicted symptom burden at baseline (F (4, 112) = 55.29, p < 0.005, R2 = 0.664). Stress (β = 0.28, p = 0.003), illness perception (β = 0.2, p = 0.03), poor social support (β = −0.22, p = 0.01) and low body weight (β = −0.19, p = 0.03) were the determinants for symptom burden at 6 months (F (5, 93) = 4.85, p ≤ 0.005, R2 = 0.24). Elevated stress, illness perception level, poor social support and low post-dialysis body weight were found to be determinants for symptom burden. Attention should be given to psychosocial factors of hemodialysis patients while conducting assessment and delivering care to patients.
Keywords: symptom burden, adults, hemodialysis, Sri Lanka, longitudinal study