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Features and diversity of symptoms of moyamoya disease in adolescents: A cluster analysis

 Won-Oak Oh  ;  Kyu Won Shim  ;  Insun Yeom  ;  Il Tae Park  ;  YooJin Heo 
 JOURNAL OF ADVANCED NURSING, Vol.77(5) : 2319-2327, 2021-05 
Journal Title
Issue Date
Adolescent ; Cluster Analysis ; Humans ; Moyamoya Disease* / epidemiology ; Nausea ; Republic of Korea ; Retrospective Studies
adolescents ; cluster analysis ; moyamoya disease ; nursing ; symptom cluster
Aims: The purpose of this study is to explore the symptoms experienced by adolescents with moyamoya disease and to identify the characteristics of each symptom cluster associated with moyamoya disease.

Design: A retrospective and descriptive design, which is a secondary data analysis study based on electronic medical record data from hospitals.

Methods: To assess the symptoms associated with moyamoya disease, a qualitative study was conducted on 12 adolescents, 12 caregivers and 12 experts on moyamoya disease. According to a qualitative study, 12 main symptoms (limb weakness, numbness, pins and needles, difficulty in speech, blurred vision, facial paralysis, hand tremors, involuntary movements, convulsions, dizziness, nausea/vomiting and headaches) were selected. Data were collected around these symptoms. The data collection was carried out through the Electronic Medical Record (EMR) data of 303 adolescents aged 13-19 who were diagnosed with moyamoya disease (ICD 10 Code: I67.5) between January 2010-December 2019 in a hospital in Seoul, South Korea. Cluster analysis was applied to identify symptom clusters with the hierarchical cluster agglomerative approach. We used the log-likelihood distance to measure the similarity of variables. Proximity between groups of variables was measured using the two-step method.

Results: The physical symptoms experienced by adolescents with moyamoya disease were 'limb weakness' - the most common - followed by a 'headache,' 'difficulty in speech,' and 'nausea/vomiting.' A total of five symptom clusters were derived: cluster 1 was characterized by 'limb weakness'; cluster 2 participants were asymptomatic or experienced 'convulsions'; cluster 3 experienced 'difficulty in speech' and 'facial paralysis'; cluster 4 is prone to 'dizziness' and 'pins and needles'; and cluster 5 displays 'headaches' and 'nausea/vomiting'.

Conclusion: This study offers a multidimensional approach for identifying differences in clinical symptoms of moyamoya disease among adolescents.

Impact: These results will help provide interventions concerning the characteristics of the symptoms of moyamoya disease among adolescents.
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1. College of Medicine (의과대학) > Dept. of Neurosurgery (신경외과학교실) > 1. Journal Papers
Yonsei Authors
Shim, Kyu Won(심규원) ORCID logo https://orcid.org/0000-0002-9441-7354
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