Symptom Experiences, Symptom Management Strategies, and Outcomes in Patients with Stage 3 and 4 Chronic Kidney Disease

Abstract

The number of patients suffering from chronic kidney disease (CKD) is increasing, but there is no pattern of assessment and management of their symptoms. This descriptive research was aimed at investigating the symptom experiences, symptom management strategies, and outcomes in patients with stage 3 and 4 CKD. The study’s participants were patients with stage 3 and 4 CKD in a tertiary care hospital in Nakhon Ratchasima province, Thailand. Seventy-eight patients were purposively selected.  Data were collected using the Symptom Experiences, Symptom Management Strategies, and Outcomes in Patients with Stage 3 and 4 CKD Questionnaire developed from the Memorial Symptom Assessment Scale. The questionnaire’s reliability was tested with 30 subjects whose demographic and clinical characteristics were similar to the subjects in the main study. The resulting Cronbach’s alpha coefficient was .78. Descriptive statistics were used to analyze the data. The study findings revealed that the top five symptom experiences were lack of energy (66.7%), pain (65.4%), frothy urine (48.7%), frequent urination (41%), and dry skin (41%). The patients’ symptom management strategies for addressing the lack of energy were sleeping and resting; for pain, it was massage; and for dry skin, it was applying body lotion. There were no strategies mentioned for managing frequent nighttime urination and frothy urine. Most of the patients tended to self-manage their symptoms before using medication or relying on medical procedures. The effective outcomes after applying these strategies are also reported. The study findings could be used to develop care plans for symptom management strategies which best serves the patients’ needs for more effective care and leading to better quality of life.