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. 2022 Oct 4;9(4):422-429.
doi: 10.1016/j.ijnss.2022.09.015. eCollection 2022 Oct.

Palliative care needs and symptom burden in younger and older patients with end-stage renal disease undergoing maintenance hemodialysis: A cross-sectional study

Xuefei Wang  1 , Qiuyin Shi  2 , Yongzhen Mo  3 , Jing Liu  4 , Yingying Yuan  1
Affiliations

Palliative care needs and symptom burden in younger and older patients with end-stage renal disease undergoing maintenance hemodialysis: A cross-sectional study

Xuefei Wang et al. Int J Nurs Sci. .

Abstract

Objectives: To investigate the current situation of palliative care needs and the symptom burden in patients with end-stage renal disease (ESRD) undergoing maintenance hemodialysis (MHD), and to explore whether there are differences between younger and older patients.

Methods: This cross-sectional study was conducted in the hemodialysis centers of two tertiary hospitals from November 2021 to June 2022. Participants were selected by convenience sampling. Socio-demographics, clinical characteristics, the Palliative Care Outcome Scale (POS), the Dialysis Symptom Index (DSI), and health-related quality of life (EQ-5D-3L) were used for evaluation. Descriptive statistics, between-group comparisons, and correlation analysis were used to analyze the data.

Results: A total of 236 patients were enrolled, including 118 younger and 118 older patients. The total median (P 25, P 75) POS score was 16.0 (12.0, 23.0), and the score was higher in older patients (P < 0.01). The mean total number of symptoms in MHD patients was 15.04 ± 5.06, and the overall median symptom severity score was 59.0 (52.0, 71.0); these scores were higher in the older group (P < 0.01). The most common symptom was dry mouth (91.5%), followed by itching (83.1%), and dry skin (82.2%). Additionally, palliative care needs were significantly associated with symptom burden and health-related quality of life (HRQOL).

Conclusions: The results showed that patients with ESRD undergoing MHD have a significant symptom burden and moderate palliative care needs, which are more severe in older patients. Therefore, interdisciplinary teams should be formed to actively manage patients' symptoms and meet the physical, psychological, social, and spiritual needs related to palliative care to improve patients' HRQOL.

Keywords: End-stage renal disease; Hemodialysis; Needs assessment; Palliative care; Quality of life; Symptom burden.

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Conflict of interest statement

There is no conflict of interest.

References

    1. GBD Chronic Kidney Disease Collaboration Global, regional, and national burden of chronic kidney disease, 1990-2017:A systematic analysis for the Global Burden of Disease Study 2017. Lancet. 2020;395(10225):709–733. doi: 10.1016/S0140-6736(20)30045-3. - DOI - PMC - PubMed
    1. Intradialytic Hypotension Prevention and Treatment Expert Working Group Renal and blood purification committee, Chinese medicine education society. Expert consensus on the prevention and treatment of intradialytic hypotension (2022) Chin J Intern Med. 2022;61:269–281. doi: 10.3760/cma.j.cn112138-20210601-00384. 03. [In Chinese] - DOI
    1. Song Y.H., Cai G.Y., Xiao Y.F., Chen X.M. Risk factors for mortality in elderly haemodialysis patients: a systematic review and meta-analysis. BMC Nephrol. 2020;21(1):377. doi: 10.1186/s12882-020-02026-x. - DOI - PMC - PubMed
    1. Wachterman M.W., O'Hare A.M., Rahman O.K., Lorenz K.A., Marcantonio E.R., Alicante G.K., et al. One-year mortality after Dialysis initiation among older adults. JAMA Intern Med. 2019;179(7):987–990. doi: 10.1001/jamainternmed.2019.0125. - DOI - PMC - PubMed
    1. Wong S.P.Y., Kreuter W., O'Hare A.M. Treatment intensity at the end of life in older adults receiving long-term dialysis. Arch Intern Med. 2012;172(8):661–663. doi: 10.1001/archinternmed.2012.268. discussion663-4. - DOI - PMC - PubMed