Symptom Interference in Thai Patients with End-Stage Renal Disease Undergoing Hemodialysis

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Charuedee Putruttanamaneekun
Yaowarat Matchim
Adis Tasanarong


Objectives: To explore the prevalence, frequency, severity, and distress of physical and psychological symptoms among end-stage renal disease (ESRD) patients undergoing hemodialysis (HD). Methods: Two hundred and three ESRD patients undergoing HD completed the Thai Memorial Symptom Assessment Scale-ESRD (the Thai MSAS-ESRD). The content validity was 0.96 and the stability reliability was 0.94 for frequency, 0.93 for severity and 0.95 for distress. The data were analyzed using descriptive statistics. Results:
The results showed that the majority of participants (98.52%) had a symptom interference, and the average number of symptoms was 11.50 (SD = 7.19). The top five prevalence of physical symptom interferences were itching (64.53%) and dry skin (64.53%), followed by lack of energy (60.59%), trouble falling asleep (57.64%), and trouble staying asleep (52.71%). The top three prevalence of psychological symptom interferences were boredom (61.08%), irritability (49.75%), and worry (39.41%). Regarding frequency, the most of physical symptom interference at the rarely level was dry skin (54.96%), whereas lack of energy (60.16%) was reported at the occasionally level. In terms of psychological symptom interference, worry (75.00%) was reported at the rarely level. Regarding severity, lack of energy (65.04%) was reported the most common of physical symptom interference, whereas worry (46.25%) was reported the most common
of psychological symptom interference. Regarding distress, trouble staying asleep (47.66%) was reported the most common of physical symptom interference, whereas boredom (29.03%) was reported the most common of psychological symptom interference. In terms of severity level and distress level, all of physical and psychological symptom interferences were reported at slightly severe level. Conclusion: Thai ESRD patients undergoing HD experience interference from multiple symptoms that need appropriate management.


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Putruttanamaneekun, C., Matchim, Y. ., & Tasanarong, A. . (2022). Symptom Interference in Thai Patients with End-Stage Renal Disease Undergoing Hemodialysis. Songklanagarind Journal of Nursing, 42(2), 12–22. Retrieved from
Research Articles
Author Biography

Charuedee Putruttanamaneekun, Faculty of Nursing, Thammasat University, Pathum Thani, Thailand.



คณะพยาบาลศาสตร์ มหาวิทยาลัยธรรมศาสตร์


James SL, Abate D, Abate KH, et al. Global, regional, and national incidence, prevalence, and years lived with disability for 354 diseases and injuries for 195 countries and territories, 1990-2017: A systematic analysis for the Global Burden of Disease Study 2017. Lancet. 2018; 392(10159): 1789-858. doi: 10.1016/S0140-6736(18)32279-7.

Hill NR, Fatoba ST, Oke JL, et al. Global prevalence of chronic kidney disease - a systematic review and metaanalysis. PloS one. 2016; 11(7): doi: 10.1371/journal. pone.0158765.

Chuasuwan A, Lumpaopong A. Prevalence of RRT [Internet]. Bangkok: The Nephrology Society of Thailand; 2020 [cite 2021 Dec 1]. Available from:

Chuasuwan A, Praditpornsilpa P. Provision of renal replacement therapy in Thailand during the year 2015 [Internet]. Bangkok:

The Nephrology Society of Thailand; 2015 [cite 2021 Jul 12] Available from:

Kidney Disease Improving Global Outcomes (KDIGO) CKD work group. KDIGO 2012 clinical practice guideline for the evaluation and management of chronic kidney disease. Kidney inter Suppl. 2013; 3(1): 1-150. doi: 10.1038/kisup.2012.76.

Murtagh FE, Addington-Hall J, Higginson IJ. The prevalence of symptoms in end-stage renal disease: A systematic review. Adv Chronic Kidney Dis. 2007; 14(1): 82-99. doi: 10.1053/j.ackd.2006.10.001.

Chaiviboontham S, Phinitkhajorndech N, Tainsaard J. Symptom clusters in patients with end-stage renal disease undergoing hemodialysis. Int J Nephrol Renovasc Dis. 2020; 13: 297-305. doi: 10.2147/IJNRD.S271619.

Tainsaard J, Chaiviboontham S, Phinitkhajorndech N. Perception of symptom burden, financial burden, and quality of life in patients with end stage renal disease undergoing hemodialysis. Rama Nurs J. 2017; 23(1): 60-77. Thai.

Delmas P, Cohen C, Loiselle M, et al. Symptoms and quality of life from patients undergoing hemodialysis in Switzerland. Clin Nurs Stud. 2018; 6(2): 63-72. doi: 10.5430/cns.v6n2p63.

Jitchan P, Masingboon K, Duangpeang S. Predictors of functional performance in patients with chronic kidney disease. JTNMC. 2011; 26(2): 86-99. Thai.

Taiwong A, Kanogsunthornrat N. The impact of symptom cluster on quality of life among patients with chronic kidney disease. SCNJ. 2018; 5(2): 175-88. Thai.

Lenz ER, Pugh LC, Milligan RA, et al. The middlerange theory of unpleasant symptoms: An update. Adv Nurs Sci. 1997; 19(3): 14-27. doi: 10.1097/00012272-199703000-00003.

Polit DF, Sherman RE. Statistical power in nursing research. Nurs Res. 1990; 39(6): 365-9.

Portenoy RK, Thaler HT, Kornblith AB, et al. The memorial symptom assessment scale: An instrument for the evaluation of symptom prevalence, characteristics, and distress. Eur J Cancer. 1994; 30A(9): 1326-36. doi: 10.1016/0959-8049(94)90182-1.

Suwisith N, Hanucharurnkul S, Dodd M, et al. Symptom clusters and functional status of women with breast cancer. Thai J Nurs Res. 2008; 12(3): 153-65. Thai.

Yu T, Sun C, Lin C, et al. Risk factors associated with endstage renal disease (ESRD) in patients with atherosclerotic renal artery stenosis: A nationwide population-based analysis. Medicine. 2015; 94(21). doi: 10.1097/MD.0000000000000912.

Srina J, Sirivongs D, Adisuk D, et al. Factors associated with rapid decline of renal function in patients with kidney disease: A retrospective cohort study. Journal of Nursing Science & Health. 2018; 41(3): 108-18. Thai.

Chaiprasert A. Chronic kidney disease. In: Thirapoj B, Chaiprasert A, Nata N, et al. editors. Manual of dialysis. Bangkok: Nam Akson printing house; 2019. Thai.

Shayakul C, editor. Hemodialysis Clinical Practice Recommendation 2014 [Internet]. Bangkok: The Nephrology Society of Thailand; 2014 [cite 2022 Feb 20]. Available from:

Thirapoj B. Complication during hemodialysis. In: Thirapoj B, Chaiprasert A, Nata N, et al. editors. Manual of Dialysis. Bangkok: Nam Akson Printing House; 2019. Thai.

Combs SA, Teixeira JP, Germain MJ. Pruritus in kidney disease. Semin Nephro. 2015; 35(4): 383-91. doi: 10.1016/j.semnephrol.2015.06.009.

Davey CH, Webel AR, Sehgal AR, et al. Fatigue in individuals with end stage renal disease. Nephrol Nurs J. 2019; 46(5): 497-508.

Kusuma H, Ropyanto CB, Widyaningsih S, et al. Relating factors of Insomnia among haemodialysis patients. Nurse Media J of Nurs. 2018; 8(1): 44-57. doi: 10.14710/nmjn.v8i1.15741.

Al-Ali F, Elshirbeny M, Hamad A, et al. Prevalence of depression and sleep disorders in patients on dialysis: A crosssectional study in Qatar. Int J Nephrol. 2021; 2021: 5533416. doi: 10.1155/2021/5533416.

Galain AI, Dapueto JJ, Alvarez R, et al. Prevalence of symptoms and symptom clusters of patients on dialysis in uruguay. Value Health Reg Issues. 2019; 20: 28-35. doi: 10.1016/j.vhri.2018.10.003.

Karasneh R, Al-Azzam S, Altawalbeh SM, et al. Predictors of symptom burden among hemodialysis patients: A crosssectional study at 13 hospitals. Int Urol Nephrol. 2020; 52(5): 959-67. doi: 10.1007/s11255-020-02458-2.

Mollaoglu M, Candan F, Mollaoglu M. Illness perception, and hopelessness in hemodialysis. Arch Clin Nephrol. 2016; 2(1): 44-8. Available from:

Almutary H, Bonner A, Douglas C. Symptom burden in chronic kidney disease: A review of recent literature. J Ren Care. 2013; 39(3): 140-50. doi: 10.1111/j.1755-6686.2013.12022.x.

Senanayake S, Gunawardena N, Palihawadana P, et al. Symptom burden in chronic kidney disease: A population based cross sectional study. BMC Nephrol. 2017; 18(228): 1-8. doi: 10.1186/s12882-017-0638-y.

Almutary H, Doyglas C, Bonner A. Toward a symptom cluster model in chronic kidney disease: A structural equation approach. J Adv Nurs. 2017; 73(10): 2450-61. doi: 10.1111/jan.13303.

Phuca W, Vongsirimas N, Thanoi W. Factors correlated with psychological well-being in patients receiving hemodialysis. Nurs Sci J Thail. 2020; 38(1): 73-85. Thai.

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