PREVALENCE OF SYMPTOMS AND CLUSTER ANALYSIS IN DIALYSIS PATIENTS USING KDQOL-36
Author(s)
Galain AI1, Alvarez R2, Dapueto JJ1, Varela A1
1Facultad de Medicina, Universidad de la República, Uruguay, Montevideo, Uruguay, 2Facultad de Ciencias Economicas, Universidad de la República, Uruguay, Montevideo, Uruguay
OBJECTIVES This study assessed the prevalence of symptoms, and symptom clusters in a sample of dialysis patients in Uruguay. METHODS A longitudinal study aimed to assess HRQL in hemo (HD) and peritoneal dialysis patients (PD) was conducted in thirteen centers in Uruguay. Data of the first assessment was included here. The 12 items of the KDQOL-36 Symptom Subscale were analyzed for symptom prevalence. For cluster analyses the ICLUST procedure was followed, using an algorithm to hierarchically cluster items to form composite scales. Alpha, the mean split half correlation, and beta, the worst split half correlation, are estimates of the reliability and general factor saturation of the test. Clusters are combined if coefficients increase in the new cluster. RESULTS Of a total of 751 patients, 486 accepted to participate and completed the forms (64.7%), with mean age 60.5 years, SD: 15.5), 211 (43.4%) were women; 407 (83.7%) were HD, and 79 (16.3%) were PD patients. Most prevalent symptoms were muscle sores (59.0 %); cramps (57.5%); “washed out” (50.9%), dry skin (48.5%), and itchy skin (43.8%). Five clusters of symptoms were identified; “cutaneous” (itchy and dry skin, α .68), ”cardiac” (chest pain and shortness of breath, α .69), ”digestive” (nausea and lack of appetite, α .62), ”neurophatic” (numbness and cramps, α .50), ”energy” (“washed out”, faintness, α .59). A second block called “locomotive” included neuropathic plus muscle sores (α .64), and a third of “neurological symptoms” included locomotive plus energy (α .70). Cutaneous symptoms remained as a separated cluster. Cronbach alpha of the total Symptom Scale was .93. CONCLUSIONS Dialysis patients experience a high number of symptoms. The study of clusters identified 5 groups of symptoms; cutaneous, cardiac, neuropathic, digestive and lack of energy. More complex associations included neurological, digestive and cardiac complaints. The identification of symptom clusters can help to understand common underlying pathways, and the use of drugs targeted to associated symptoms.
Conference/Value in Health Info
2014-11, ISPOR Europe 2014, Amsterdam, The Netherlands
Value in Health, Vol. 17, No. 7 (November 2014)
Code
PUK33
Topic
Patient-Centered Research
Topic Subcategory
Patient-reported Outcomes & Quality of Life Outcomes
Disease
Urinary/Kidney Disorders