[Evidence of lack of concordance between hemodialysis patients and nurses on the presence and severity of symptoms.]

Hemodialysis patients represent a fragile population experiencing many symptoms (e.g., pain, fatigue) that impact their quality of life. The presence and severity of these symptoms are significantly underestimated by health professionals. The purpose of this study is to describe and compare the symptoms perceived by hemodialysis patients versus those detected by nurses and to discuss the possible causes of the disparity observed. A total of 123 patients and 70 nurses working in six hemodialysis centers were included in this study. The results show that participating nurses detected less than 50% of symptoms perceived by patients. The concordance between the hemodialysis patients and the nurses' responses on the presence and severity of all symptoms is very low (Kappa<0.4). Therefore, improving the knowledge and skills of hemodialysis nurses in detecting the symptoms of hemodialysis patients they treat appears to be one of the central areas for effective intervention and improved quality of care.