Earlier studies have demonstrated an association between patient perceived symptom burden and psychosocial factors in different patient populations. Social support has previously been shown to be associated with reduced physical symptom burden, as well as reduced stress and anxiety in dialysis patients. However, the association between social support and symptom burden is not fully understood given the limited research on this topic.
In this study we investigate the association of perceived social support and self-reported symptom burden in dialysis patients.
A cross-sectional, convenience sample of adult patients on maintenance dialysis were recruited from several dialysis clinics in the Greater Toronto Area. Non-English speaking patients, and patients who previously had a kidney transplant were excluded. Social support and symptom burden was assessed with self-report questionnaires; the Medical Outcome Study Social Support Survey (MOS-SSS) and the Edmonton Symptom Assessment Survey (ESAS) questionnaire, respectively. Multiple imputation was used to handle missing data. Multivariable adjusted linear regression models were used to assess the association between perceived social support and symptom burden. Box Cox transformation was used to normalize the distribution of ESAS Global scores.
We analyzed 165 participants: mean (SD) age of 54(13) years, 104 males (63%). Amongst all participants, 97 (59%) had less than 12 years of education, 72 (44%) had spent <2 years on dialysis. Overall social support was correlated with symptom burden (rs =-0.28, p=0.001). After adjusting for socio-economic variables (age, gender, ethnicity, education, marital status, income), overall social support was associated with lower symptom burden (?=-0.53, 95%CI, -0.86, -0.21; p=0.001). The association remained significant even after adjusting for additional clinical variables ( comorbidity, time on dialysis) (?=-0.51, 95%CI, -0.82, -0.19; p=0.002).
These results suggest that higher perceived social support is associated with lower symptom burden in patients on maintenance dialysis. Further research is needed to assess the impact of improving social support on health outcomes.