Symptoms and Management Strategies for Older Chinese Adults with End Stage Renal Disease (ESRD) and Other Chronic Conditions (GP792)

Abstract

• Name common, bothersome symptoms symptoms in adult Chinese-American ESRD patients.• Identify strategies reported by adult Chinese-American ESRD patients to ameliorate the identified symptoms. Over $50 billion is spent on elderly patients with chronic kidney disease in the United States; with 1.5 times higher incidence of end stage renal disease (ESRD) in Asian Americans compared to Caucasians, there is a dire need to improve self-care and symptom management studies for this population. ESRD patients typically have a very short life expectancy and do not qualify for hospice benefits while they remain on dialysis or transplant lists. There are calls to strengthen palliative care for ESRD patients to help decrease distressing symptoms. Chinese-American patients have low use of both hospice and palliative care and may withdraw from hospice even when enrolled, resulting in few Chinese-American patients receiving the benefits of palliative care. To identify common, bothersome symptoms and strategies used to ameliorate these symptoms in adult Chinese-American ESRD patients. Using purposive sampling, elderly Chinese-Americans were surveyed for commonly occurring symptoms using standardized instruments and open-ended questions to identify strategies used to ameliorate those symptoms. Thirty Chinese-American participants were recruited with an average age of 80 (SD =13.08). They scored higher-than-average for constipation and lower than average for quality of life (QoL) measures. There were statistically significant higher levels of nausea and vomiting in those with ESRD and diabetes (p = 0.042), pruritus in those who also had heart disease and ESRD (p = 0.002), and fatigue for those with ESRD and arthritis compared to those without (p = 0.048). Strategies were reported for 8 common symptoms: fatigue, pain, sleep disturbance, dyspnea, anxiety, nausea and vomiting, constipation and pruritus. On average, participants reported fewer symptoms compared to the general population but scored lower for QoL. Further exploration is needed to understand this phenomenon and to validate the reported amelioration strategies.