Purpose: To identify symptom clusters among patients with chronic kidney
Methods: The study design is descriptive research. Based on the Theory of Unpleasant Symptoms. The sample consisted of 150 patients with stage 3-4 chronic kidney disease who received care at an outpatient chronic kidney disease clinic of a tertiary hospital in the northeastern region of Thailand. Data were collected from January to March 2016. Research instruments included the patient data record form and the unpleasant symptom assessment. Data were analyzed using descriptive statistics and factor analysis.
Results: Results revealed an additional symptom cluster aside from those included in the evaluation, which is burning pain on the legs and feet, which totaled to 28 unpleasant symptoms in patients with stage 3-4 of chronic kidney disease, with an average of 7.44 (SD= 3.76). These symptoms could be categorized into 6 core symptom clusters according to the dimensions of frequency, severity and both in the dimensions of 43.536 percent, 42.924 percent, and 41.647 percent, respectively. Each symptom clusters comprised of 2-5 unpleasant symptoms, including symptom cluster of the mental and emotional condition, peripheral nerves abnormality, fatigue, gastro-intestinal tract problem, pain, and uremic symptom. Each group has an internal consistency as well as Cronbach's alpha between.81 and .91. The top 3 symptom clusters that were able to describe the variance among each dimensions included symptom clusters of the mental and emotional condition, peripheral nerves abnormality and fatigue.
Conclusion: This study exhibits the similarity of unpleasant symptom clusters across the dimensions of frequency, severity and frequency along with severity in stage 3-4 chronic kidney disease patients. Nurses could use dimension as a mean to assess the unpleasant symptoms and develop a care plan to manage symptom clusters as found in this study, especially among the top 3 symptom clusters that can explain the highest variance.