| Object The aim of the study was to develop an restless legs syndrome (RLS)screening questionnaire for nurses in dialysis units to help improve doctor’s diagnosis rate of RLS. Also, using the questionnaire to investigate the prevalence rate and analyze the possible associated risk factors of RLS in dialysis patients, in order to provide evidence for clinical guidance and the late intervention study.Method The study was divided into two parts. The first part is the development of an RLS screening questionnaire. Firstly, setting up a research team mainly responsible for the items selection. Through literature reviewing to understand the current researches trend about RLS assessment tools and the characteristics of RLS in dialysis patients, then developing initial items based on RLS universal scales. Secondly, by group discussion, content validity assessment and pre-survey to further modified items and form the initial questionnaire. Thirdly.185 CAPD patients were selected to conduct the formal survey. Using item discrimination analysis, correlation analysis, internal consistency test and exploratory factor analysis to further select items. The best score is made by ROC curve. The reliability and validity were uesd to evaluate the questionnaire. The second part is a cross-sectional survey of RLS. Using the RLS screening questionnaire to survey the dialysis patients who met the inclusion criteria, and the definite diagnosis was made by a specialist according to the criterion published by International Organization of restless legs. Social-demographic data including age, gender, occupation, education level, BMI and whether having type 2 diabetes, relevant dialysis information including duration of dialysis, dialysis type and Kt/V and laboratory(calcium, phosphorus, albumin, hemoglobin, ferritin, serum creatinine before dialysis, urea nitrogen and PTH were collected.Result ①Restless leg syndrome questionnaire for dialysis patients consisted of 11 items, Cronbach’α coefficient was 0.957, test-retest reliability was 0.748, content validity was 0.91 with one factor, the cumulative contribution rate of 71.913%. According to ROC curve analysis, taking six as the score for screening RLS. ②Totally 448 patients including 222 male and 226 female were enrolled in the study, the mean age was 58.03 ± 14.14 years, the mean duration of dialysis was 4.69±4.18 years.63 patients were screened as high-risk patients and 52 patients were finally diagnosed as RLS. The prevalence rate of RLS is 11.6%. Dialysis patients with restless leg syndrome is younger than the non-RLS patients(52.88±12.04 vs 61.84±14.23,P=0.000), the prevalent rate of RLS in CAPD patients was higher than MHD patients (39/13 vs 146/200, P=0.000) and serum creatinine was higher than non-RLS patients(1044.90±291.69 vs 929.47±281.60, P=0.009). The multivariate logistic regression analysis showed that the age was protective factor of RLS(OR=0.964,P=0.009)and the CAPD was risk factor of RLS(OR=5.797, P=0.000).Conclusion ①The RLS questionnaire for dialysis patients has good reliability and validity, it can screen high-risk patients from dialysis patients, and can help doctors diagnose and reach the purpose of improving correct diagnosis rate. ②Pathogenesis of RLS in dialysis patients is complex, the detailed mechanism remains to be further discussed. In this study, age is protective factor of RLS and CAPD is independent risk factor of RLS. |
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