Hemodialysis patients' symptom experiences: effects on physical and mental functioning

Abstract

Dialysis patients experience numerous symptoms, some serious in terms of medical outcomes and all serious in terms of potential reductions in functioning and well-being. This cross-sectional study used self-reports of hemodialysis patients to catalogue symptoms; hypothesizing that frequently experienced symptoms, regardless of acuity, negatively affect functioning and well-being. Data were collected from 307 randomly selected hemodialysis patients from 14 dialysis facilities. Twenty-two of the 47 symptoms queried had mean experience scores of > or = 1 on a scale of 0-4, that is, were experienced by patients at least "a little of the time." Seventeen of these 22 symptoms were significantly correlated (< or = .01) with the SF-36 Physical Component Summary (PCS) scale, Mental Component Summary (MCS) scale, or both. All but four of these 17 symptoms (dry mouth, itchy skin, lack of appetite, and restless legs) clustered around fatigue/sleep, sexual concerns, or mobility. Linear multiple regression showed age, diabetes, the fatigue/sleep and mobility clusters, and itchy skin to be negatively associated with the PCS (p < or = .01). The fatigue/sleep cluster was also negatively associated with the MCS. Because previous research has shown the PCS and MCS to be associated with morbidity and mortality, management of common, non-acute symptoms may have long-term benefits for hemodialysis patients.