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dc.contributor.authorAlmutary, H
dc.contributor.authorDouglas, C
dc.contributor.authorBonner, A
dc.date.accessioned2020-12-09T00:00:34Z
dc.date.available2020-12-09T00:00:34Z
dc.date.issued2017
dc.identifier.issn0309-2402en_US
dc.identifier.doi10.1111/jan.13303en_US
dc.identifier.urihttp://hdl.handle.net/10072/400098
dc.description.abstractAims: The aim of this study was to test a symptom cluster model in chronic kidney disease patients based on the Theory of Unpleasant Symptoms, accounting for the relationships between influencing factors, symptom experience and consequences for quality of life. Background: The evaluation of symptom clusters is a new field of scientific inquiry directed towards more focused symptom management. Yet, little is known about relationships between symptom clusters, predictors and the synergistic effect of multiple symptoms on outcomes. Design: Cross-sectional. Methods: Data were collected from 436 patients with advanced stages of chronic kidney disease during July 2013–February 2014 using validated measures of symptom burden and quality of life. Analysis involved structural equation modelling. Results: The final model demonstrated good fit with the data and provided strong evidence for the predicted relationships. Psychological distress, stage of chronic kidney disease and age explained most of the variance in symptom experience. Symptom clusters had a strong negative effect on quality of life, with fatigue, sexual symptoms and restless legs being the strongest predictors. Overall, the model explained more than half of the deterioration in quality of life. However, a reciprocal path between quality of life and symptom experience was not found. Conclusions: Interventions targeting symptom clusters could greatly improve quality of life in patients with chronic kidney disease. The symptom cluster model presented has important clinical and heuristic implications, serving as a framework to encourage and guide new lines of intervention research to reduce symptom burden in chronic kidney disease.en_US
dc.description.peerreviewedYesen_US
dc.languageEnglish
dc.language.isoeng
dc.publisherWileyen_US
dc.relation.ispartofpagefrom2450en_US
dc.relation.ispartofpageto2461en_US
dc.relation.ispartofissue10en_US
dc.relation.ispartofjournalJournal of Advanced Nursingen_US
dc.relation.ispartofvolume73en_US
dc.subject.fieldofresearchNursingen_US
dc.subject.fieldofresearchcode1110en_US
dc.subject.keywordsTheory of Unpleasant Symptomsen_US
dc.subject.keywordschronic kidney diseaseen_US
dc.subject.keywordsstructural equation modellingen_US
dc.subject.keywordssymptom clustersen_US
dc.titleTowards a symptom cluster model in chronic kidney disease: A structural equation approachen_US
dc.typeJournal articleen_US
dc.type.descriptionC1 - Articlesen_US
dcterms.bibliographicCitationAlmutary, H; Douglas, C; Bonner, A, Towards a symptom cluster model in chronic kidney disease: A structural equation approach, Journal of Advanced Nursing, 2017, 73 (10), pp. 2450-2461en_US
dcterms.dateAccepted2017-02-16
dc.date.updated2020-12-08T23:56:46Z
dc.description.versionAccepted Manuscript (AM)en_US
gro.rights.copyright© 2017 John Wiley & Sons Ltd. This is the peer reviewed version of the following article: Towards a symptom cluster model in chronic kidney disease: A structural equation approach, Journal of Advanced Nursing, 2017, 73 (10), pp. 2450-2461, which has been published in final form at https://doi.org/10.1111/jan.13303. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Self-Archiving (http://olabout.wiley.com/WileyCDA/Section/id-828039.html)en_US
gro.hasfulltextFull Text
gro.griffith.authorBonner, Ann J.


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