การจัดการอาการของผู้ที่เป็นโรคไตเรื้อรังระยะสุดท้ายที่ได้รับการล้างไตทางช่องท้องอย่างต่อเนื่อง

Abstract

People with end - stage renal disease receiving continuous ambulatory peritoneal dialysis often experience symptoms in the dimensions of symptoms occurrence, frequency, severity and distress. These may impact the patients’ daily life. Therefore, symptom management is needed to relieve the distress caused by receiving continuous ambulatory peritoneal dialysis in people with end - stage renal disease. The objective of this descriptive research was to study the management of symptoms of people with end - stage renal disease receiving continuous ambulatory peritoneal dialysis. The participants consisted of both male and female end - stage renal disease patients receiving continuous ambulatory peritoneal dialysis aged 18 years and over, who visited the kidney disease clinic, outpatient department in 4 hospitals in Chiang Mai province between November 2019 and February 2020. The participants (n=293) were purposively selected to complete three instruments, which were 1) the general data record form, 2) the CKD Symptom Burden Index (CKD-SBI), and 3) the symptoms management interview form of persons with end - stage renal disease receiving continuous ambulatory peritoneal dialysis. Data were analyzed using descriptive statistics. The results demonstrated that: 1. The participants perceived itching as being the symptom experienced in the most in terms of symptom occurrence as 67.23 % and the mean score of frequency, severity and distress dimension were X̅ ± SD = 4.51 ± 1.62, 4.59 ± 1.34, and 5.53 ± 1.70, respectively 2. The participants used various methods to manage 5 symptoms, including: 1) itching which was managed by applying cream or lotion (84.80 %), gently scratching using hand/cloth/scratch stick (72.10 %), and avoiding red and processed meat (44.70 %); 2) bone or joint pain was managed by general touch/squeezing (86.70 %), topical analgesics (36.40 %), and oral paracetamol (34.30 %); 3) muscle soreness was managed by relaxation in a sitting position or lying down (90.30 %), general touch/squeezing (80.60 %), and oral paracetamol (34.70 %); 4) muscle cramps were managed by foot stretching/contraction/ankle flexing (77.10 %), squeezing/massaging/pressing on symptomatic areas (74.80 %), and leg stretching (61.80 %); and 5) headaches were managed by relaxation or resting in a sitting position or lying down (94.50 %), self - measurement and recording of blood pressure (67.90 %), and squeezing/massaging/pressing on symptomatic areas (49.50 %). The results of this research will provide basic information for nurses and health care personnel for assessing symptom experience, and may be a guidance for the planning of care and recommending or promoting symptom management of people with end - stage renal disease receiving continuous ambulatory peritoneal dialysis appropriately and efficiently.