The Surprise Question and Health-Related Quality of Life in Patients on Hemodialysis: A Cross-Sectional Multicenter Study
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...
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Mary Ann Liebert
2024-10-01
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| Series: | Palliative Medicine Reports |
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| Online Access: | https://www.liebertpub.com/doi/10.1089/pmr.2023.0093 |
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| author | Jeanette M. Wallin Stefan H. Jacobson Lena Axelsson Jenny Lindberg Carina I. Persson Jenny Stenberg Agneta Wennman-Larsen |
| author_facet | Jeanette M. Wallin Stefan H. Jacobson Lena Axelsson Jenny Lindberg Carina I. Persson Jenny Stenberg Agneta Wennman-Larsen |
| author_sort | Jeanette M. Wallin |
| collection | DOAJ |
| description | 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. |
| format | Article |
| id | doaj-art-579a24fc24ec408ca97101cb06179dbb |
| institution | OA Journals |
| issn | 2689-2820 |
| language | English |
| publishDate | 2024-10-01 |
| publisher | Mary Ann Liebert |
| record_format | Article |
| series | Palliative Medicine Reports |
| spelling | doaj-art-579a24fc24ec408ca97101cb06179dbb2025-08-20T01:49:57ZengMary Ann LiebertPalliative Medicine Reports2689-28202024-10-015130631510.1089/pmr.2023.0093The Surprise Question and Health-Related Quality of Life in Patients on Hemodialysis: A Cross-Sectional Multicenter StudyJeanette M. Wallin0Stefan H. Jacobson1Lena Axelsson2Jenny Lindberg3Carina I. Persson4Jenny Stenberg5Agneta Wennman-Larsen6Department of Nursing Science, Sophiahemmet University, Stockholm, Sweden.Division of Nephrology, Department of Clinical Sciences, Karolinska Institutet, Danderyd Hospital, Stockholm, Sweden.Department of Nursing Science, Sophiahemmet University, Stockholm, Sweden.Department of Clinical Sciences, Unit of Medical Ethics, Lund University, Lund, Sweden.Department of Research, Region Kalmar County, Kalmar, Sweden.Department of Medical Sciences, Uppsala University, Uppsala, Sweden.Department of Nursing Science, Sophiahemmet University, Stockholm, Sweden.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.https://www.liebertpub.com/doi/10.1089/pmr.2023.0093communicationhealth-related quality of lifehemodialysispalliative careSurprise Question |
| spellingShingle | Jeanette M. Wallin Stefan H. Jacobson Lena Axelsson Jenny Lindberg Carina I. Persson Jenny Stenberg Agneta Wennman-Larsen The Surprise Question and Health-Related Quality of Life in Patients on Hemodialysis: A Cross-Sectional Multicenter Study Palliative Medicine Reports communication health-related quality of life hemodialysis palliative care Surprise Question |
| title | The Surprise Question and Health-Related Quality of Life in Patients on Hemodialysis: A Cross-Sectional Multicenter Study |
| title_full | The Surprise Question and Health-Related Quality of Life in Patients on Hemodialysis: A Cross-Sectional Multicenter Study |
| title_fullStr | The Surprise Question and Health-Related Quality of Life in Patients on Hemodialysis: A Cross-Sectional Multicenter Study |
| title_full_unstemmed | The Surprise Question and Health-Related Quality of Life in Patients on Hemodialysis: A Cross-Sectional Multicenter Study |
| title_short | The Surprise Question and Health-Related Quality of Life in Patients on Hemodialysis: A Cross-Sectional Multicenter Study |
| title_sort | surprise question and health related quality of life in patients on hemodialysis a cross sectional multicenter study |
| topic | communication health-related quality of life hemodialysis palliative care Surprise Question |
| url | https://www.liebertpub.com/doi/10.1089/pmr.2023.0093 |
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