Multidimensional evaluation: an example to be applied in dialysis

Between June and July 2005 we submitted the IPPE survey (Pluridimensional Record for Hemodialysis Patient) to 61 chronic hemodialysis patients of our Centre. The aim of the survey was to estimate the six most important components in the life of patients undergoing chronic dialysis: familiar relationships, relationship with their own body, need of drinking, daily life, general needs, disease perception. The most critical factor is the need of drinking, followed by the problems about body feelings and daily life. Disease perception and familiar relationships seem to be less important problems. Regarding patients needs of medical and nursing care and about the condition of in-hospital patient, there is a strong lack of information about diagnosis (72%), a high request of better discussion with doctors (69%) and the need of a greater involvement in the therapeutic choices (57%), related to the difficult communication between doctor and patient. 30% of the interviewed patients would like to have more attention by the nurses: this aspect is not due to the absence of the nurse but rather to a lack of empathy between nurse and patient. These data should be seen as a reason for improving medical and nursing care, because being aware of problems is the first step to their solution.