Abstract:

Objective To identify the types，composition，and influencing factors of symptom clusters in kidney transplant recipients during the early postoperative period，and to provide guidance for healthcare professionals in implementing precise symptom management strategies. Methods A total of 183 kidney transplant recipients who underwent renal transplantation in a tertiary hospital in Tianjin from May 2024 to March 2025 were enrolled as the research subjects by convenience sampling. The investigation was conducted using a general information questionnaire and the Chinese version of Modified Transplant Symptom Occurrence and Symptom Distress Scale. Exploratory factor analysis was employed to extract symptom clusters，and multiple stepwise linear regression was used to identify the influencing factors of symptom clusters. Results 180 valid questionnaires were recovered，with a valid response rate of 98.36%. Totally 4 symptom clusters were identified during the early postoperative phase by exploratory factor analysis，including energy deficiency symptom cluster，hormone disorder symptom cluster，emotional-sleep symptom cluster，and skin discomfort symptom cluster. Results of multiple stepwise linear regression showed that age，marital status，employment status，medical payment method，living situation，dialysis duration，preoperative comorbidities，blood glucose，and hemoglobin were influencing factors of symptom clusters（P<0.05）. Conclusion Kidney transplant recipients experience complex symptom profiles during the early postoperative period，which are influenced by demographic characteristics and disease-related factors. Healthcare providers should adopt symptom clusters as intervention modules and target influencing factors to develop precise symptom management strategies，thereby reducing the early postoperative readmission rate.

Key words: Kidney Transplantation, Symptom Cluster, Root Cause Analysis, Nursing Care

摘要：

目的 明确肾移植患者术后早期症状群种类及影响因素，为医护人员对肾移植患者实施精准的症状管理提供指导。方法 采用便利抽样法，选取2024年5月—2025年3月在天津市某三级甲等医院接受肾移植手术的183例肾移植患者作为调查对象，采用一般资料调查表和中文版改良移植症状发生和症状困扰量表进行调查，采用探索性因子分析提取症状群，利用多元逐步线性回归分析明确症状群的影响因素。结果 回收有效问卷180份，有效问卷回收率为98.36%。肾移植患者术后提取出了能量缺乏症状群、激素紊乱症状群、情绪睡眠症状群和皮肤不适症状群。多元逐步线性回归分析结果显示，年龄、婚姻状况、工作状态、医疗付费方式、居住情况、移植前透析时长、移植前合并症、血糖、血红蛋白是症状群的影响因素（P<0.05）。结论 肾移植患者术后早期存在复杂的症状经历，受人口学特征与疾病相关因素的影响。医护人员应以症状群为干预模块，以影响因素为靶点，制订精准的症状管理方案，以降低肾移植患者术后早期再入院率。

关键词: 肾移植, 症状群, 影响因素分析, 护理