Evaluation of uraemic pruritus in long-term dialysis patients using a modified Chinese scale.
OBJECTIVE
To examine the reliability and validity of a modified Chinese version of the uraemic pruritus scale for measurement of different degrees of itching, as well as to identify the predictors for the severity of uraemic pruritus among long-term dialysis patients.


METHODS
Long-term dialysis patients (n = 110) were recruited for a cross-sectional study from a medical centre in Taiwan. A modified Chinese version of the uraemic pruritus scale was used to evaluate sleep disturbance and the severity, frequency and distribution of itching. Reliability was evaluated using item-total correlations, Cronbach's α, and intra-class correlation. Validity was evaluated by the content validity index, predictive and discriminative validity. Multiple linear regression was used on the predictors for the severity of uraemic pruritus.


RESULTS
After optimization for reliability, the scale retained seven items. The Cronbach's α was 0.86, and the results showed that the scale had predictive and discriminative validity. High intact-parathyroid hormone and creatinine clearance rate were important predictors for the severity of uraemic pruritus. The severity of uraemic pruritus was the important predictor for the sleeping disturbance.


CONCLUSIONS
The modified uraemic pruritus scale can discriminate between patients with a total pruritus score of ≥11 and those with a score of 0 points. The modified Chinese scale is a useful tool for clinically assessing the various degrees of itching among long-term dialysis patients. Our study validates that it could apply to clinical practice in assessment of uraemic pruritus.
Graduate Institute of Medical Sciences, National Defense Medical Centre, Taipei, Taiwan.|Department of Nursing, Tri-Service General Hospital, Taipei, Taiwan.
Wei-Yun
WY
Wang
Division of Nephrology, Department of Medicine, Taipei, Taiwan.|Department and Institute of Physiology, National Yang-Ming University, Taipei, Taiwan.
Der-Cherng
DC
Tarng
School of Nursing, National Defense Medical Centre, Taipei, Taiwan.
Li-Chi
LC
Chiang
School of Public Health, National Defense Medical Centre, Taipei, Taiwan.
Chi-Ming
CM
Chu
Graduate Institute of Medical Sciences, National Defense Medical Centre, Taipei, Taiwan.|Department of Nursing, Taipei Veterans General Hospital, Taipei, Taiwan.
Kwua-Yun
KY
Wang
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019540:Area Under Curve; D016009:Chi-Square Distribution; D003430:Cross-Sectional Studies; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D010530:Peritoneal Dialysis; D011237:Predictive Value of Tests; D011537:Pruritus / Q000175:diagnosis* / Q000209:etiology; D012372:ROC Curve; D006435:Renal Dialysis; D015203:Reproducibility of Results; D012307:Risk Factors; D012720:Severity of Illness Index; D012890:Sleep; D012893:Sleep Wake Disorders / Q000175:diagnosis* / Q000209:etiology / Q000503:physiopathology; D011795:Surveys and Questionnaires; D013624:Taiwan; D013997:Time Factors; D014511:Uremia / Q000150:complications* / Q000175:diagnosis / Q000628:therapy; D055815:Young Adult
dialysis; pruritus; reliability; validity