Cross-sectional validity of a modified Edmonton symptom assessment system in dialysis patients: A simple assessment of symptom burden
Cross-sectional validity of a modified Edmonton symptom assessment system in dialysis patients: A simple assessment of symptom burden
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DOI：
10.1038/sj.ki.5000184
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发表时间：
2006-05-01
影响因子：
19.6
通讯作者：
Johnson, JA
中科院分区：
文献类型：
--
作者：
Davison, SN;Jhangri, GS;Johnson, JA
主观症状评估应该是终末期肾病（ESRD）健康相关生活质量（HRQL）评估的基本组成部分。不幸的是，没有症状自评量表已建立可靠性或有效性在终末期肾病。我们报告了在507名同时完成肾透析生活质量简表（KDQOL- SF）问卷的透析患者中对改良的埃德蒙顿症状评估系统（ESAS）的验证。ESAS显示平均7.572.5个症状。报告的最严重症状是疲劳、健康、食欲和疼痛。总体症状困扰评分与KDQOL-SF子量表症状/问题列表密切相关（r =-0.69，P < 0.01），肾脏疾病的影响（r =-0.52，P < 0.01），肾脏疾病负担兰德-12生理健康综合评分（PHC）和兰德-12心理健康综合评分（MHC）均低于对照组（r=-0.54，P <0.01）。在多变量回归分析中，在使用改良的Charlson合并症指数控制了包括合并症在内的潜在混杂变量后，ESAS症状困扰评分与MHC（斜率= -0.82 +/-0.07，P < 0.01）和PHC（斜率= -0.48 +/-0.07，P < 0.01）仍然密切相关。ESAS症状困扰评分占PHC损害的29%，占MHC损害的39%。1周重测中症状困扰总分的组内相关系数为0.70，P < 0.01。症状负担高，对透析患者的HRQL产生不利影响。改良ESAS是一种可靠、有效、简单、有用的方法，可用于该患者人群的定期症状评估。
Subjective symptom assessment should be a fundamental component of health-related quality of life (HRQL) assessment in end-stage renal disease ( ESRD). Unfortunately, no symptom checklist has established reliability or validity in ESRD. We report the validation of a modified Edmonton Symptom Assessment System (ESAS) in 507 dialysis patients who concurrently completed the Kidney Dialysis Quality of Life-Short Form (KDQOL- SF) questionnaire. The ESAS demonstrated a mean of 7.572.5 symptoms. The symptoms reported as most severe were tiredness, well-being, appetite, and pain. The overall symptom distress score was strongly correlated with the KDQOL-SF subscales symptom/problem list (r = -0.69, P < 0.01), effects of kidney disease (r = -0.52, P < 0.01), and burden of kidney disease (r = -0.50, P < 0.01), as well as lower RAND-12 physical health composite ( PHC) (r= -0.54, P < 0.01) and lower RAND-12 mental health composite (MHC) (r = -0.62, P < 0.001). In the multivariate regression analysis, after controlling for potential confounding variables including comorbidity using the modified Charlson Comorbidity Index, the ESAS symptom distress score remained strongly associated with the MHC (slope = -0.82 +/- 0.07, P < 0.01) and PHC (slope = -0.48 +/- 0.07, P < 0.01). The ESAS symptom distress score accounted for 29% of the impairment in PHC and 39% of the impairment in MHC. The intraclass correlation coefficient for the total symptom distress score in a 1-week test-retest was 0.70, P < 0.01. Symptom burden is high and adversely affects HRQL in dialysis patients. The modified ESAS is a reliable, valid, simple, and useful method for regular symptom assessment in this patient population.