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首页> 外文期刊>AIDS care. >A novel symptom cluster analysis among ambulatory HIV/AIDS patients in Uganda
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A novel symptom cluster analysis among ambulatory HIV/AIDS patients in Uganda

机译：乌干达门诊HIV / AIDS患者的新型症状聚类分析

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摘要

Symptom clusters are gaining importance given HIV/AIDS patients experience multiple, concurrent symptoms. This study aimed to: determine clusters of patients with similar symptom combinations; describe symptom combinations distinguishing the clusters; and evaluate the clusters regarding patient socio-demographic, disease and treatment characteristics, quality of life (QOL) and functional performance. This was a cross-sectional study of 302 adult HIV/AIDS outpatients consecutively recruited at two teaching and referral hospitals in Uganda. Socio-demographic and seven-day period symptom prevalence and distress data were self-reported using the Memorial Symptom Assessment Schedule. QOL was assessed using the Medical Outcome Scale and functional performance using the Karnofsky Performance Scale. Symptom clusters were established using hierarchical cluster analysis with squared Euclidean distances using Ward's clustering methods based on symptom occurrence. Analysis of variance compared clusters on mean QOL and functional performance scores. Patient subgroups were categorised based on symptom occurrence rates. Five symptom occurrence clusters were identified: Cluster 1 (n = 107), high-low for sensory discomfort and eating difficulties symptoms; Cluster 2 (n = 47), high-low for psycho-gastrointestinal symptoms; Cluster 3 (n = 71), high for pain and sensory disturbance symptoms; Cluster 4 (n = 35), all high for general HIV/AIDS symptoms; and Cluster 5 (n = 48), all low for mood-cognitive symptoms. The all high occurrence cluster was associated with worst functional status, poorest QOL scores and highest symptom-associated distress. Use of antiretroviral therapy was associated with all high symptom occurrence rate (Fisher's exact = 4, P < 0.001). CD4 count group below 200 was associated with the all high occurrence rate symptom cluster (Fisher's exact = 41, P < 0.001). Symptom clusters have a differential, affect HIV/AIDS patients' self-reported outcomes, with the subgroup experiencing high-symptom occurrence rates having a higher risk of poorer outcomes. Identification of symptom clusters could provide insights into commonly co-occurring symptoms that should be jointly targeted for management in patients with multiple complaints.
机译：考虑到艾滋病毒/艾滋病患者经历多种并发症状，症状群正在变得越来越重要。这项研究的目的是：确定具有相似症状组合的患者群;描述区分群集的症状组合;并评估有关患者社会人口统计学，疾病和治疗特征，生活质量（QOL）和功能表现的聚类。这是对在乌干达的两家教学医院和转诊医院连续招募的302名成人HIV / AIDS门诊病人进行的横断面研究。使用“纪念症状评估时间表”自我报告了社会人口统计学和7天期间的症状患病率和痛苦数据。使用医疗结果量表评估生活质量，并使用卡诺夫斯基绩效量表评估功能表现。使用基于症状发生率的Ward聚类方法，通过平方欧氏距离的分层聚类分析，建立症状聚类。方差分析比较了根据平均生活质量和功能绩效得分进行的聚类。根据症状发生率对患者亚组进行分类。确定了五个症状发生群集：群集1（n = 107），感觉不适和饮食困难症状的高-低;第2类（n = 47），为心理-胃肠症状的高-低;第3类（n = 71），对疼痛和感觉障碍症状较高;类别4（n = 35），对于一般的HIV / AIDS症状都很高;和聚类5（n = 48），对于情绪认知症状均较低。所有高发人群均与最差的功能状态，最差的QOL评分和最高的症状相关困扰有关。抗逆转录病毒疗法的使用与所有较高的症状发生率相关（Fisher精确= 4，P <0.001）。低于200的CD4计数组与所有高发生率症状簇相关（Fisher精确= 41，P <0.001）。症状群具有差异，影响艾滋病毒/艾滋病患者的自我报告结局，该亚组的高症状发生率具有较高的不良后果风险。症状群的识别可以为常见的共同出现的症状提供洞察力，这些症状应共同针对具有多个主诉的患者进行管理。

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