Skip to main content

Lund University Publications

LUND UNIVERSITY LIBRARIES

The Surprise Question and Health-Related Quality of Life in Patients on Hemodialysis : A Cross-Sectional Multicenter Study

Wallin, Jeanette M ; Jacobson, Stefan H ; Axelsson, Lena ; Lindberg, Jenny LU ; Persson, Carina I ; Stenberg, Jenny and Wennman-Larsen, Agneta (2024) In Palliative Medicine Reports 5(1). p.306-315
Abstract

BACKGROUND: The Surprise Question (SQ) is a common method aimed at identifying frail patients who need serious illness conversations to integrate a palliative approach. However, little is known about whether the SQ identifies patients on hemodialysis who perceive that they are declining or have low health-related quality of life (HRQoL)-important aspects when considering the need for serious illness conversations.

OBJECTIVE: To explore how nurses and physicians' responses to the SQ are associated with patients' self-reported HRQoL.

DESIGN: Cross-sectional study.

SUBJECTS: In total, 282 patients on hemodialysis were included.

MEASUREMENTS: One nurse and one physician responded to the SQ for each patient. The... (More)

BACKGROUND: The Surprise Question (SQ) is a common method aimed at identifying frail patients who need serious illness conversations to integrate a palliative approach. However, little is known about whether the SQ identifies patients on hemodialysis who perceive that they are declining or have low health-related quality of life (HRQoL)-important aspects when considering the need for serious illness conversations.

OBJECTIVE: To explore how nurses and physicians' responses to the SQ are associated with patients' self-reported HRQoL.

DESIGN: Cross-sectional study.

SUBJECTS: In total, 282 patients on hemodialysis were included.

MEASUREMENTS: One nurse and one physician responded to the SQ for each patient. The patient-reported HRQoL was measured with the RAND 36-Item Health Survey 1.0 (RAND-36) and the EuroQual vertical visual analogue scale (EQ-VAS) from the EuroQual-5 Dimension Questionnaire (EQ-5D).

RESULTS: Nurses' responses "no, not surprised" to the SQ were associated with patient-reported worsened health compared to one year ago (RAND-36), and lower perceived overall health (EQ-VAS). Physicians' responses "no, not surprised" were associated with lower overall health and lower physical functioning. Patient-reported pain, general health, fatigue, and emotional and social aspects were not associated with responses to the SQ.

CONCLUSIONS: The findings indicate that the SQ identifies patients on hemodialysis who report low overall health and low physical functioning. However, the SQ did not identify patients who reported pain, emotional problems, or fatigue, which are also important aspects to consider in identifying needs for serious illness conversations, symptom management, and to be able to integrate a palliative approach.

(Less)
Please use this url to cite or link to this publication:
author
; ; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Palliative Medicine Reports
volume
5
issue
1
pages
306 - 315
publisher
Mary Ann Liebert, Inc.
external identifiers
  • pmid:39144133
  • scopus:85200561017
ISSN
2689-2820
DOI
10.1089/pmr.2023.0093
language
English
LU publication?
yes
additional info
© Jeanette M. Wallin et al., 2024; Published by Mary Ann Liebert, Inc.
id
598e5593-b016-4f1d-b5bb-2d4ff3cb59ae
date added to LUP
2024-08-16 16:48:24
date last changed
2024-08-31 06:20:20
@article{598e5593-b016-4f1d-b5bb-2d4ff3cb59ae,
  abstract     = {{<p>BACKGROUND: The Surprise Question (SQ) is a common method aimed at identifying frail patients who need serious illness conversations to integrate a palliative approach. However, little is known about whether the SQ identifies patients on hemodialysis who perceive that they are declining or have low health-related quality of life (HRQoL)-important aspects when considering the need for serious illness conversations.</p><p>OBJECTIVE: To explore how nurses and physicians' responses to the SQ are associated with patients' self-reported HRQoL.</p><p>DESIGN: Cross-sectional study.</p><p>SUBJECTS: In total, 282 patients on hemodialysis were included.</p><p>MEASUREMENTS: One nurse and one physician responded to the SQ for each patient. The patient-reported HRQoL was measured with the RAND 36-Item Health Survey 1.0 (RAND-36) and the EuroQual vertical visual analogue scale (EQ-VAS) from the EuroQual-5 Dimension Questionnaire (EQ-5D).</p><p>RESULTS: Nurses' responses "no, not surprised" to the SQ were associated with patient-reported worsened health compared to one year ago (RAND-36), and lower perceived overall health (EQ-VAS). Physicians' responses "no, not surprised" were associated with lower overall health and lower physical functioning. Patient-reported pain, general health, fatigue, and emotional and social aspects were not associated with responses to the SQ.</p><p>CONCLUSIONS: The findings indicate that the SQ identifies patients on hemodialysis who report low overall health and low physical functioning. However, the SQ did not identify patients who reported pain, emotional problems, or fatigue, which are also important aspects to consider in identifying needs for serious illness conversations, symptom management, and to be able to integrate a palliative approach.</p>}},
  author       = {{Wallin, Jeanette M and Jacobson, Stefan H and Axelsson, Lena and Lindberg, Jenny and Persson, Carina I and Stenberg, Jenny and Wennman-Larsen, Agneta}},
  issn         = {{2689-2820}},
  language     = {{eng}},
  number       = {{1}},
  pages        = {{306--315}},
  publisher    = {{Mary Ann Liebert, Inc.}},
  series       = {{Palliative Medicine Reports}},
  title        = {{The Surprise Question and Health-Related Quality of Life in Patients on Hemodialysis : A Cross-Sectional Multicenter Study}},
  url          = {{http://dx.doi.org/10.1089/pmr.2023.0093}},
  doi          = {{10.1089/pmr.2023.0093}},
  volume       = {{5}},
  year         = {{2024}},
}