Analysis of concurrent symptom networks and identification of symptom clusters in kidney transplant recipients

Objective To explore the symptom clusters in renal transplant recipients and construct a concurrent symptom network to identify core symptoms.

Methods A total of 343 patients with followed up after renal transplantation were selected as the study subjects. A general information questionnaire and the Chinese version of the Modified Transplant Symptom Occurrence and Symptom Distress Scale were employed to analyze the occurrence of symptoms in patients. In this study, only symptoms with an incidence rate greater than 20% and Spearman correlation coefficient greater than 0.40 between symptom severity and total score were retained. Exploratory factor analysis was used to extract symptom clusters with a factor loading of ≥0.45 as the criterion. The R language was utilized to construct symptom network, based on which core symptoms and bridge symptoms were identified.

Results A total of 5 symptom clusters were extracted in this study: the neuro-gastrointestinal symptom cluster, the mood-related symptom cluster, the hormone-related symptom cluster, the energy deficiency symptom cluster and the vision-related symptom cluster. The core symptoms were anxiety (r_s=1.75), mood swings (r_s=1.50) and muscle weakness (r_s=1.27). The top three symptoms in terms of bridge strength were muscle weakness (r_b=0.87), lack of vitality (r_b=0.66) and fatigue (r_b=0.65).

Conclusion Multiple symptoms are presented in patients after renal transplantation. Based on the results of symptom network analysis, clinicians can strengthen the assessment of core symptoms and bridge symptoms to develop precise intervention strategies and improve the effectiveness of symptom management.