DOI: 10.1177/17449871231225397 ISSN: 1744-9871

Cross-cultural validation of the Portuguese version of the Dialysis Symptom Index for haemodialysis patients

João Pedro Barros, João Almeida Fonseca, Rui Pinto, Jorge Pratas, Ricardo João Cruz Correia
  • Research and Theory


Patients with end-stage renal disease (ESRD) undergoing haemodialysis (HD) are associated with low quality of life (QoL) and high disease-related symptoms. The patient self-report instruments can assess the burden of physical and psychological symptoms. The Dialysis Symptom Index (DSI) is a specific instrument to evaluate the multidimensional reported symptoms by patients undergoing HD.


To translate, validate and assess the psychometric properties of the Portuguese version of the DSI.


A cross-cultural adaptation process from English to Portuguese and a validation study ( n = 156) were conducted. Reliability, validity and responsiveness were assessed.


The patients’ most reported symptoms were, nausea ( n = 86, 55%), muscle cramps ( n = 92, 59%), feeling tired or lack of energy ( n = 92, 59%), bone or joint pain ( n = 88, 56%) and trouble staying asleep ( n = 95, 60%). Cronbach’s alpha of the DSI was 0.87, and intraclass correlation coefficient was 0.868 (95%CI 0.836–0.896). The smallest detectable change was 28.32.


The Portuguese DSI demonstrates excellent psychometric properties for assessing HD patients’ reported symptoms. It highlights symptom severity and impact, providing valuable insights for healthcare practitioners. Nurses can use the DSI to tailor interventions and enhance patient-centred care.

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