基于网络分析维持性血液透析患者症状群及桥梁症状研究

Bridge symptoms among symptom clusters in maintenance hemodialysis patients:a network analysis

目的 探索维持性血液透析患者不同症状群间的关联关系,识别连接不同症状群的桥梁症状。方法 采用便利抽样法,使用透析症状指数量表对480例维持性血液透析患者进行问卷调查。基于网络分析识别症状群间的桥梁症状。结果 维持性血液透析患者经历着6个症状群,分别为皮肤症状群、尿毒症症状群、胃肠道症状群、情绪症状群、水电解质症状群与性功能障碍症状群。桥梁中心性指标显示桥梁强度最大的症状是担心(r_(bs)=7.946)和皮肤干燥(r_(bs)=7.800);桥梁紧密中心性最大的症状是担心(r_(bc)=0.331)和伤心(r_(bc)=0.322);桥梁中介中心性最大的症状是性欲减退(r_(bb)=12.000)和入睡困难(r_(bb)=7.000)。结论 维持性血液透析患者受多个症状群困扰,担心和皮肤干燥是连接不同症状群的桥梁症状。针对桥梁症状进行精准干预,有利于阻断其在不同症状群间的桥接作用,提高症状管理效能。

Objective To explore the interrelationships among symptom clusters in maintenance hemodialysis(MHD)patients and to identify bridge symptoms among the symptom clusters.Methods A total of 480 MHD patients were selected using convenience sampling method.They were investigated by utilizing the dialysis symptom index scale.The network analysis was used to identify bridge symptoms among symptom clusters.Results The MHD patients experienced six symptom clusters,namely uremia symptom cluster,gastrointestinal symptom cluster,emotional symptom cluster,skin symptom cluster,water electrolyte symptom cluster,and sexual dysfunction symptom cluster.According to the index of bridge centrality,worrying(r_(bs)=7.946)and dry skin(r_(bs)=7.800)had the highest bridge strength;worrying(r_(bc)=0.331)and feeling sad(r_(bc)=0.322)had the highest bridge closeness;decreased interest in sex(r_(bb)=12.000)and trouble falling asleep(r_(bb)=7.000)had the highest bridge betweenness.Conclusion MHD patients are troubled by multiple symptom clusters.Worrying and dry skin are bridge symptoms among different symptom clusters.Accurate intervention of bridge symptoms is beneficial to block the bridging effect between different symptom clusters and improve the efficiency of symptom management.