Latent class analysis of symptom characteristics in maintenance hemodialysis patients and their relationship with quality of life

ObjectiveTo explore the symptom characteristics of maintenance hemodialysis patients，and to analyze the differences in patients' quality of life in different categories.MethodsA total of 341 patients from the blood purification center of a tertiary grade A hospital in Hangzhou from October 2022 to June 2023 were selected by convenience sampling method.A cross⁃sectional survey was conducted using the general information questionnaire,Dialysis Symptom Index(DSI)and Kidney Disease Quality of Life⁃36(KDQOL⁃36TM).Latent class analysis of structural equation model was used to analyze the symptom categories of maintenance hemodialysis patients.One⁃way analysis of variance was used to explore the relationship between different types of symptoms and patients' quality of life.ResultsThe symptoms of maintenance hemodialysis patients could be divided into four latent class according to their characteristics:sleep disorder symptom group(55.4%)，low symptom group(23.5%),uremic syndrome symptom group(10.6%) and skin problem symptom group(10.6%).There were statistically significant differences in the scores of symptom burden，kidney disease impact,kidney disease burden，body composition and psychological composition among the 4 symptom classes(P<0.001).There were significant differences in age，employment，education and marital status among different categories of patients(P<0.05).Further multiple Logistic regression analysis showed that education level and marital status were the influencing factors in the latent classes typing of symptom characteristics in maintenance hemodialysis patients(P<0.05).ConclusionsThe symptoms of maintenance hemodialysis patients can be divided into four latent classes：sleep disorder symptom group，low symptom group，uremic syndrome symptom group and skin problem symptom group.The quality of life of patients with uremic syndrome symptom group is the worst，and the quality of life of patients with low symptom group is the best.Emphasis should be placed on symptom assessment and management of dialysis patients who are less educated and unmarried/divorced/widowed.