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end-stage renal disease, palliative care, symptom management, symptoms



  1. Jablonski, Anita PhD, RN


The primary purpose of this investigation was to document the level of relief that patients with end-stage renal disease treated with hemodialysis obtain from their symptoms. Anecdotal clinical observations suggest that these patients' symptoms are not effectively relieved and that they would benefit from palliative care services that specialize in symptom management. Findings support this observation and indicate that patients' quality of life is diminished in the presence of symptoms that are neither effectively nor satisfactorily relieved. This research focuses attention on inequities present in the current healthcare system that prevent dialysis patients from accessing specialized services that have helped to improve the lives of patients with other chronic illnesses. This study supports the recommendations made by the Robert Wood Johnson Foundation End-stage Renal Disease Workgroup urging the incorporation of palliative care into routine nephrology practice.