Development And Application Of Symptom Distress Scale In Peritoneal Dialysis Patients

ObjectiveTo develop a symptom distress assessment instrument for patients undergoing peritoneal dialysis;to evaluate the status of symptom distress with peritoneal dialysis patients in terms of the presence or absence of symptoms and degree of distress,and to explore the effect of demographic and disease-related data on symptom distress undergoing peritoneal dialysis.Methods1.On the basis of the adapted Dialysis Symptom Index,through the literature review and semi-structured interviews with medical staff and patients,we constructed the pool of symptoms of peritoneal dialysis patients.Using the Delphi method,10 experts selected in peritoneal dialysis field,two rounds of experts' interviews were conducted on 10 experts selected in peritoneal dialysis field,Whether or not the symptoms occur is in the form of "having" and "nothing",and the level of distress is 0to 4 points,forming a pre-test scale for symptom distress of peritoneal dialysis patients.Pre-tests were performed on 50 patients to evaluate the reliability and reliability of the questionnaire,and to further modify and perfect the scale to form a tentative scale.270 peritoneal dialysis patients were surveyed to evaluate thereliability and validity of the scale to form a formal version symptom distress scale in peritoneal dialysis patients.2.With stratified sampling method,286 peritoneal dialysis patients from four peritoneal dialysis center of Henan Province will be investigated using symptom distress scale in peritoneal dialysis patients,demographic and disease-related information to evaluate the status of symptom distress in peritoneal dialysis patients,exploring the effect of demographic and disease-related data on symptom distress undergoing peritoneal dialysis.3.Excel2010 software was used for data entry,and data was analyzed by SPSS21.0.CVI was used to evaluate the content validity of the scale.Using exploratory factor analysis to evaluate the construct validity of the scale,using Cronbach's alpha coefficient evaluate the internal consistency reliability,using the r value and P value to evaluate the test-retest reliability;in the part of statistical description,demographic and disease-related data will be expressed using mean and standard deviation or frequency and percentage.Using two independent samples t test,one-way analysis of variance to analyze the patient's symptom distress under different demographic data and disease-related data,and multiple linear regression was used to explore the relevant factors affecting the symptoms distress of peritoneal dialysis patients.Determine whether the difference was statistically significant by P <0.05.Results1.The overall content validity index of symptom distress scale developed by peritoneal dialysis patients was 0.900,and the content validity index of each item was between 0.800 and 1.00.Factorial analysis was used to analyze the construct validity of the Symptom Assessment Scale for peritoneal dialysis patients.Five common factors were obtained,the cumulative variance contribution rate was 59.463%,and load values of each item on its common factor are was above 0.4 The total Cronbach's coefficient of the entire scale is 0.917,and the Cronbach's coefficient of each dimension is between 0.795 and 0.904.The test-retest reliability of this study was determined by r and P values,The r values of all subscales were above 0.7,P wereblow 0.001.It shows that the scale has good reliability and validity.2.A questionnaire survey of 286 peritoneal dialysis patients from 4 peritoneal dialysis centers in Henan Province was conducted.A total of 280 valid questionnaires were recovered.The effective recovery rate was 97.90%.Study shows that patients with peritoneal dialysis have more severe symptoms distress.Results of two independent samples t test,one-way analysis of variance: there is no significant difference in the total Kt / V values and weekly Ccr values,differ gender,marital status,educational level(P> 0.05).A significant difference was observed between symptom distress of patients undergoing peritoneal dialysis at age,,dialysis age,working-place,per capita monthly household income,whether with complications,hemoglobin,plasma albumin,primary disease and peritoneal type in patients with peritoneal dialysis(P <0.05).The results of multiple linear regression analysis showed that seven variables among the factors influencing the symptom distress of patients included in the regression equation were peritoneal type,primary disease,whether with complications,hemoglobin,plasma albumin,per capita monthly household income,age.Conclusions1.Symptom distress scale of Peritoneal dialysis patients has a good reliability and validity,and can be used for evaluation of symptom distress of peritoneal dialysis patients.2.Peritoneal dialysis patients has higher levels of symptoms distress,the patient's peritoneal type,primary disease,whether with complications,hemoglobin,plasma albumin,per capita monthly household income and age are the main factors affecting the patient's symptom distress.