肾移植术后居家患者症状群及影响因素

Symptom clusters in stay-at-home kidney transplant recipients and the influencing factors

目的了解肾移植术后居家患者的症状及症状群,探讨症状群的影响因素,为肾移植术后居家患者的症状管理提供参考。方法采用便利抽样法选择224例肾移植术后居家患者,采用症状经历量表、领悟社会支持量表、疾病进展恐惧简化量表、肾移植自我管理量表进行调查。探索性因子分析提取症状群,多元线性回归分析影响症状群的因素。结果肾移植术后居家患者发生率最高的前5位症状为感到疲累(83.48%)、手颤(79.02%)、情绪波动(75.45%)、难以集中注意力/记性差(75.45%)和烦躁/紧张不安(74.11%)。探索性因子分析确定5个症状群,分别为心理-认知-活力相关症状群、能量不足症状群、不适症状群、免疫力降低相关症状群与激素相关症状群。自我管理与疾病进展恐惧感为5个症状群的独立预测因子(P<0.05,P<0.01)。结论肾移植术后居家患者承受着多种症状的困扰,医护人员应积极关注居家患者的症状管理,加强患者的自我管理意识,减轻疾病进展恐惧,以改善其生活质量。

Objective To identify symptoms and symptom clusters in kidney transplant recipients staying at home,to explore the influencing factors of symptom clusters,and to provide reference for postoperative symptom management.Methods Totally,224 kidney transplant recipients staying at home were selected using convenience sampling and completed a battery of questionnaires including the Chinese Version of Modified Transplant Symptom Occurrence and Symptom Distress Scale,Perceived Social Support Scale,Fear of Progression Questionnaire,and Kidney Transplant Self-management Scale.Exploratory factor analysis was applied to extract symptom clusters,and multiple linear regression analysis was used to determine factors affecting the symptom clusters.Results The 5 most prevalent symptoms were fatigue(83.48%),trembling hands(79.02%),mood swings(75.45%),concentration difficulties(75.45%)and anxious/nervous(74.11%).Exploratory factor analysis identified five symptom clusters:psycho-cognitive-vigor-related,energy-deficient,discomfort,immune-related,and hormone-related.Self-management behavior and fear of disease progression were independent predictors of 5 symptom clusters(P<0.05,P<0.01).Conclusion Kidney transplant recipients staying at home suffer from various symptoms.Medical staff should pay attention to symptom management of kidney transplant recipient staying at home,strengthen their self-management awareness,and alleviate fear of progression,thus to improve their quality of life.