Evidence of lack of agreement between hemodialysis patients and nurses on presence and severity of symptoms.

Hemodialysis patients constitute a vulnerable population whose quality of life is affected by the many symptoms (e.g., pain, fatigue) they experience. The presence and severity of these symptoms are significantly under-assessed by health professionals. The purpose of this study was to describe and compare the symptoms perceived by hemodialysis patients versus those detected by nurses. A total of 123 patients and 70 nurses working in six hemodialysis centers were included in the study. The results show that participating nurses detected less than 50% of the symptoms perceived by patients. Agreement between hemodialysis patients and nurses regarding symptom presence and severity was slight to fair at best (kappa < 0.47). This suggests that improving the knowledge and skills of hemodialysis nurses for detecting the symptoms of the patients in their care could go a long way toward intervening more efficiently and improving the quality of the care they offer.