Validation of the IPOS-Renal Symptom Survey in Advanced Kidney Disease: A Cross-sectional Study

Context: The significant symptom burden in advanced renal disease is often poorly recognized by clinicians. Recently, theIntegrated Palliative Outcome Score (IPOS)erenal survey was developed from pre-existing tools to capture these symptomsand other common concerns.Objectives: We studied the validity and reliability of the IPOS-renal survey (patient and staff versions) in an Australianpopulation.Methods: Adult patients with advanced renal disease and nurses caring for them were participated. We initiallyadministered the IPOS-renal survey simultaneously with other validated surveys and then retested the IPOS-renal after sevento 14 days. We tested the construct validity of 1) IPOS-renal patient version in relation to the Edmonton Symptom AssessmentSurveyerevised and the Kidney Diseases quality of lifeeshort form version 1.3 questionnaire and 2) IPOS-renal staff version inrelation to the Support Team Assessment Schedule survey.Results: Eighty-one patients (65 hemodialysis, 10 peritoneal dialysis, and six on supportive care; average age 64.9 years) and53 nurses (average renal nursing experience 10.9 years) were participated. Intraclass coefficients for test-retest reliability were>0.7 for most queries; Cronbach’s alphas for internal consistency were 0.84 (patient version) and 0.91 (staff version). In testsof construct validity, Spearman’s coefficient of correlation between surveys and their comparators for similar questions wassignificant, at 0.61 to 0.77 (patients) and 0.24 to 0.76 (staff). As expected, symptom scores and total symptom burden werenegatively correlated with summary scores of quality of life.Conclusion: The IPOS-renal surveys, patient and staff versions, have good test-retest reliability, internal consistency, andconstruct validity in patients with advanced kidney disease and their nurses. We recommend their use in symptomassessment