Symptom Clusters and Quality of Life in Patients on Hemodialysis

Purpose: The purpose of the study was to investigate symptom clusters experienced by patients on hemodialysis and to identify relations between symptom clusters and quality of life. Methods: Data were collected from127 patients at 10 local hemodialysis clinics. Symptoms were measured using 10-item physical symptom checklist as well as the Hospital Anxiety depression Scale. Quality of life was measured with the Satisfaction with Life Scale. Data were analyzed using factor analysis, Pearson correlation, and stepwise multiple regression. Results: The most frequently reported symptoms included fatigue, itching, depression, numbness/tingling, and insomnia. Four distinct symptom clusters were identified: cluster 1 was comprised of dry mouth, headache, nausea (gastrointestinal); cluster2 ofdecreased appetite, insomnia (basic need); cluster 3 of itching, numbness/tingling (sensory-comfort); and cluster4 offatigue, depression(mood-vitality). Among the clusters, the 'basicneed' clusterand 'mood-vitality' clusterhad a significant negative associationwith quality of life. The 'mood-vitality' cluster, explained 17.4% of the variance in quality of life. Conclusion: The results of the study indicate that comprehensive symptom assessment provides better symptom management for patients on hemodialysis. Further studies are needed to verify symptom clusters identified in this study.