Purpose: To investigate the symptom clusters that influence quality of life among patients with chronic kidney disease.
Methods: The study design is predictive research. 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, the unpleasant symptom assessment, and the SF-36 questionnaire. Data were analyzed using descriptive statistics, factor analysis, and multiple regression analysis.
Results: The sample group experienced 28 unpleasant symptoms. Moreover, the patients have moderate to good quality of life (between the range 49.78 to 92.68), with a good average score on the overall quality of life, physical component and mental component (Mean=73.20, SD=9.02; Mean =71.99, SD=1.67 and Mean =74.42, SD=1.08, respectively). Furthermore, symptoms were categorized into six core symptom clusters, including symptom cluster of the mental and emotional condition, peripheral nerves abnormality, fatigue, gastro-intestinal tract problem, pain, and uremic symptoms. All six symptom clusters was able to describe cumulative variance at 47.647 and all, except for symptom clusters of the gastro-intestinal tract problem, have a statistically negative significant impact on the quality of life. Symptom clusters were found to be significant predictors for quality of life, which includes symptom clusters of pain (Beta = -.220; p < .05) and the mental and emotional conditions (Beta=-.204; p < .05). The two symptom clusters had a statistically significant predictive value of 19.10 % (R2=.191, p < .05).
Conclusion: This study indicates that the symptom cluster of pain and the mental and emotional condition could worsen the patients’ quality of life. Nurses should be attentive in managing the two symptom clusters to facilitate the quality of life among patients with chronic kidney disease.