# Symptom Burden, Self-Efficacy, and Satisfaction with Nursing Care in Adults Undergoing Hemodialysis in Oman: A Cross-Sectional Study

## TL;DR

This study explores how symptoms, self-efficacy, and nursing care satisfaction are related in hemodialysis patients in Oman.

## Contribution

The study identifies associations between symptom burden, self-efficacy, and nursing care satisfaction in hemodialysis patients in Oman.

## Key findings

- High satisfaction with nursing care was reported despite moderate self-efficacy and significant symptom burden.
- Self-efficacy was positively correlated with patient satisfaction and laboratory indicators.
- Symptom burden was common but generally mild to moderate in severity.

## Abstract

Background: Adults on maintenance hemodialysis experience multiple physical and psychological symptoms that can affect confidence in self-management and perception of care received from healthcare providers. Understanding the interplay between symptom burden, self-management self-efficacy, and perceptions about care received is essential to inform patient-centered nephrology nursing. Aim: This cross-sectional study aimed to describe dialysis symptom burden, self-efficacy to manage chronic disease, and satisfaction with nursing care, and to examine associations among these variables in adults undergoing maintenance hemodialysis in Oman. Methods: A cross-sectional study using consecutive sampling was conducted among 232 adults on maintenance hemodialysis at two dialysis units in Muscat, Oman. Data were collected using the Dialysis Symptom Index, the nursing care satisfaction questionnaire, and the self-efficacy scale. Descriptive, correlation, and multivariable linear regression analysis were used to summarize the findings. Results: The mean age was 55.9 years and the most common comorbidities were diabetes (58.2%) and hypertension (74.1%). Symptom burden was substantial, with over half reporting muscle soreness, anxiety, sleep disturbance, dry mouth, pruritus, appetite loss, and dyspnea, although severity was generally mild–moderate (1.1–1.6/4). Satisfaction with nursing care was high (90.2%), while self-efficacy was moderate (mean 30.52/44). Patient satisfaction correlated positively with self-efficacy (r = 0.25, p < 0.001), but not with symptom burden (r = 0.08, p = 0.24); Self-efficacy showed a small positive correlation with dialysis symptom burden (r = 0.14, p = 0.03), suggesting that patients who were more aware of and reported more symptoms also perceived themselves as more actively engaged in managing their illness. In multivariable analysis, higher satisfaction and more favorable laboratory indicators independently predicted higher self-efficacy. Conclusions: Adults on hemodialysis reported high satisfaction with nursing care but continued to experience multiple physical and psychological symptoms and had only moderate self-efficacy to manage their condition. There is a need to integrate structured symptom assessment and targeted, nurse-led self-management support intervention into routine dialysis care to reduce symptom burden and enhance patients’ confidence in managing their illness.