Background: Dialysis patients experience multiple symptoms impairing their quality of life. A relationship seems to exist between the cultural context and the burden of symptoms. In this study, the prevalence and severity of 30 symptoms and their relationship with quality of life among hemodialysis patients in Switzerland is explored. Methods: A cross-sectional correlation design was used with a convenience sample of 119 patients from five dialysis units. Presence and severity of symptoms were assessed with the Dialysis Symptom Index and quality of life with the WHOQOL-Bref questionnaire. Multivariate linear regressions were used to examine the relationship between the prevalence and severity of symptoms, respectively, and quality of life. T-tests and Fisher's tests were used for the international comparisons. Results: On average, patients reported 10 symptoms and often rated these as "somewhat bothersome". The most frequent were: lack of energy, dry skin, trouble falling asleep, trouble staying asleep, and muscle cramps. Average symptoms prevalence and severity levels were both observed to decrease patients' quality of life, items related to physical health and psychological state having the greatest impact. Prevalence and severity of psychological symptoms and prevalence of sex-related symptoms seem to be influenced by patients' cultural context. Conclusions: These results demonstrate that patients on chronic hemodialysis present several symptoms that affect their quality of life. Healthcare professionals should develop strategies to identify more properly these symptoms, especially sex-related and psychological symptoms.

Aim Despite its importance in nursing, perceived quality of the nurse–patient relationship has seldom been researched. This study sought to examine and compare the quality of caring attitudes and behaviours as perceived by haemodialysis patients and their nurses. Design This comparative descriptive study involved 140 haemodialysis patients and 101 nurses caring for them in ten haemodialysis units in the French‐speaking part of Switzerland. Methods Participants completed a sociodemographic questionnaire and the Caring Nurse‐Patient Interaction Scale (CNPI‐70). Results Both nurses and patients reported a high frequency of caring attitudes and behaviours. Patients gave higher ratings than nurses did on all the caring dimensions, except spirituality. Implications are discussed.

Background Nurses are trained to establish a trusting relationship with patients to create an environment promoting patients’ quality of life. However, in tech-heavy care settings, such as haemodialysis units, dehumanising practices may emerge and take root for various reasons to the potential detriment of both patients and nurses. For patients, this may lead to a deterioration of quality of life and, ultimately, of health status. For nurses, it may cause a deterioration of the work environment and, in turn, of quality of working life. Based on Watson’s Theory of Human Caring, we developed a brief educational intervention for haemodialysis nurses to strengthen their humanistic practice in the aim of improving the nurse-patient relationship and nurse quality of working life.. The intervention was tested by way of an experimental design. Methods One hundred and one haemodialysis nurses, recruited in ten hospitals in French-speaking Switzerland, were randomised into an experimental group that received the intervention and a control group. The nurse-patient relationship was measured with the Caring Nurse-Patient Interaction Scale (EIIP-70) and nurse quality of life at work was measured with the Quality of Work Life Questionnaire at four time points: pre-intervention, intervention completion, and six-month and one-year follow-ups. Random intercept regression analysis was used to evaluate change over time in the two variables under study. Results The intervention appeared to reinforce nurse attitudes and behaviours geared to a more humanistic practice. The effect seemed to fade over time but, 1 year post-intervention, six dimensions of the nurse-patient relationship (hope, sensibility, helping relationship, expression of emotions, problem solving, teaching) scored above baseline. Nurse quality of working life, too, seemed positively impacted. The cultural dimension of nurse quality of working life, that is, the degree to which everyday work activities attune with personal and cultural values, seemed positively impacted, as well, with improvement stable throughout the year following the intervention. Conclusions Results support a positive effect of the intervention over both the short term and the medium-to-long term. A brief intervention of the sort may constitute an effective means to improve the nurse-patient relationship by preventing or reducing dehumanising practices. Trial registration NCT03283891.

BackgroundHumanistic nursing practice constitutes the cornerstone of the nursing profession. However, according to some authors, such practice tends to fade over time in favour of non-humanistic behaviours. To contrast this tendency, an educational intervention (EI) based on Watson’s Theory of Human Caring was developed and tested in two pilot studies involving, respectively, rehabilitation nurses in Quebec (Canada) and haemodialysis (HD) nurses in Switzerland. In light of the positive results obtained in these, another study is being undertaken to examine more in depth the EI’s effects on both HD nurses and patients in French Switzerland. The EI is expected to have positive effects on quality of nurse-patient relationship (NPR), team cohesion, nurse quality of working life (QoWL), and patient quality of life (QoL).Methods/designThe study described in this protocol will use a mixed-method cluster randomised controlled trial design. For the quantitative component, nurse and patient data will be collected through questionnaires. The accessible population of 135 nurses and 430 patients will be clustered into 10 HD units. These units will be randomised into an experimental group (EG) and a waiting-list control group (WLCG). Measurements will be taken at baseline (pre-intervention) and repeatedly over time (post-intervention): immediately at EI completion and six and 12 months thereafter. For the qualitative portion of the study, 18 semi-structured interviews will be conducted with EG nurses picked at random two months after EI completion to explore perceived changes in nurse humanistic practice. Qualitative data will be analysed through the relational caring inquiry method, a phenomenological approach. Descriptive and inferential statistics will be computed from the quantitative data.DiscussionThe study described in this protocol will determine if and how the proposed EI promotes humanistic nursing practice and how this practice affects quality of NPR, nurse QoWL, and patient QoL. Moreover, it will lay the groundwork for offering the EI to nurses in other healthcare sectors.Trial registrationThis clinical study was registered with ClinicalTrials.gov [NCT03283891, 14/09/2017].

Aim The aim of the study was to describe and compare feeling of competence regarding humanistic caring in Registered Nurses (RN) and nursing students (NS). Design A quantitative comparative cross‐sectional research design was used. Methods A convenience sample of 196 RN and 47 NS in a teaching hospital in Belgium completed a self‐administered questionnaire composed of a sociodemographic survey and the Caring Nurse‐Patient Interactions Scale (CNPI‐23) developed by Cossette et al. Results The four dimensions of the CNPI‐23 were compared using the Skillings–Mack test. Both groups scored higher on “humanistic” and “comforting” than on “clinical” and “relational” care and both scored lowest on this last dimension. Linear regressions showed that none of the variables had a statistically significant influence on the CNPI‐23 scores, except for NS “state of health,” which influenced their feeling of competence regarding “relational care.”

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.

During the COVID-19 pandemic, nurses were exposed to many stressors, which may have been associated with some mental health problems. However, most of the studies carried out on nurses’ quality of life and workplace wellbeing during the COVID-19 pandemic took a pathogenic approach. Given that current scientific knowledge in this field presented too many gaps to properly inform preventive and therapeutic action, the aim of this study was to explore whether protective factors (resilience, perceived social support, and professional identification) and stressors (perceived stress and psychosocial risks in the workplace) influenced the quality of life and workplace wellbeing perceived by Portuguese nurses during the COVID-19 pandemic. Data for this cross-sectional study was collected through online self-administered questionnaires. Linear regression models were used to analyze the relationships between variables. Results showed that perceived stress, resilience and job satisfaction were associated with quality of life and workplace wellbeing among Portuguese nurses. The study’s findings could serve to inform health policy and should draw the attention of nursing managers to the needs and difficulties reported by nurses, to the importance of providing them with emotional support, and to the relevance of promoting a good work environment.

Background: Chronic kidney disease (CKD) is a fast-growing cause of morbidity and mortality worldwide. Patients suffering from CKD almost always develop end-stage renal disease (ESRD) that is often treated with haemodialysis (HD). In this context, the quality of the nurse-patient relationship (NPR) plays a major role in supporting the quality of life (QoL) of HD patients. This study examined the relationship between quality of nurse behaviours and attitudes as perceived by HD patients and QoL of these patients.Methods: The study used a cross-sectional correlational design. The sample consisted of 140 patients recruited in 10 HD units in French-speaking Switzerland. The Caring Nurse-Patient Interaction Scale (CNPI-70) was used to assess the NPR, and the French version of the WHOQOL-Bref was used to evaluate different dimensions of QoL. Random-intercept linear regressions adjusted for sociodemographic characteristics were used to study the relationship between patient-perceived quality of nurse caring attitudes and behaviours and patient QoL.Results: Patients reported a high frequency of caring attitudes and behaviours from their attending nurses, except relative to the dimension of spirituality. All the dimensions of patient QoL were positively influenced by the caring factor composing the CNPI-70. In particular, nurse attention to patient dignity when providing support for basic human needs seemed to be a major factor in patient QoL.Conclusions: Quality of NPR is essential to improving patient QoL. Interventions need to be developed to support quality of NPR.