Thirst distress scale for hemodialysis patients

ABSTRACT

Thirst is the most frequently occurring symptom in hemodialysis patients. An increase in thirst is usually associated with an increase in both fluid intake and an increase in weight gain. Intervention to reduce the symptom of thirst may provide a meaningful way to decrease intra-dialytic weight gain [IWG] and prevent associated complications. The purpose of the present study was to develop and test the psychometric properties of an instrument to measure thirst in hemodialysis patients. Hemodialysis Unit of the Main University Hospital / Alexandria University and Hemodialysis Unit of El Mouassat Hospital. Instrument development study. Two hundred and four adult patients receiving thrice-weekly outpatient hemodialysis therapy. Four dimensions of thirst were conceptualized in the instrument development in this study as follows thirst intensity, distress, duration, and frequency. During a midweek scheduled hemodialysis session, participants were asked to verbally respond to the items based on experiences with thirst since their last dialysis treatment. The items were scored on 5-point rating scale from 1 [strongly disagree] to 5 [strongly agree]. Data were analyzed using the Statistical Package for Social Sciences [SPSS 10.0] and LISREL [LISREL 8.3]. Reliability was assessed using item analysis, and coefficient alpha. Validity was tested using confirmatory factor analysis, exploratory factor analysis, and relationship testing of constructs identified in the theoretical model. The sample age ranged from 18 to 74 years with a mean of 5 3 +/- 14.8 years. The individual's mean daily interdialytic weight gain [IWG] since the last hemodialysis treatment was 1.2 +/- 0.7 Kg. The mean thirst intensity was 54.23 +/- 27.31. The final thirst distress scale had 6 items whose correlations ranged from 0.43 to 0.68 and the Cronbach's alpha for the thirst distress scale was satisfactory [0.78]. The mean thirst distress score was 17.1 +/- 4.2. There was a positive relationship between thirst distress and IWG [r=0.17, P < 0.01], and also between thirst distress and thirst intensity [r=0.31, P<0.001]. The present study provided evidence for the reliability and validity of the thirst distress scale proposed herein. Although this scale was initially developed for use in a research study, it appears to have potential for use in a clinical setting, particularly in conjunction with measures that may be related to weight gain. The scale could also be tested on patients without end stage renal disease, such as persons with congestive heart failure