PDF(Pubmed)
Abstract：
UNASSIGNED: 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.
UNASSIGNED: To explore how nurses and physicians\' responses to the SQ are associated with patients\' self-reported HRQoL.
UNASSIGNED: Cross-sectional study.
UNASSIGNED: In total, 282 patients on hemodialysis were included.
UNASSIGNED: 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).
UNASSIGNED: 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.
UNASSIGNED: 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.
UNASSIGNED: To explore how nurses and physicians\' responses to the SQ are associated with patients\' self-reported HRQoL.
UNASSIGNED: Cross-sectional study.
UNASSIGNED: In total, 282 patients on hemodialysis were included.
UNASSIGNED: 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).
UNASSIGNED: 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.
UNASSIGNED: 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.
摘要：
■惊喜问题（SQ）是一种常见的方法，旨在识别需要进行严重疾病对话的虚弱患者，以整合姑息治疗方法。然而,对于SQ是否识别出认为自己正在下降或与健康相关的生活质量（HRQoL）较低的血液透析患者，这是考虑需要进行严重疾病对话时的重要方面，我们知之甚少。
■探讨护士和医师对SQ的反应如何与患者自我报告的HRQoL相关。
■横断面研究。
■总共，包括282例血液透析患者。
■一名护士和一名医生对每位患者的SQ做出反应。患者报告的HRQoL使用RAND36项健康调查1.0（RAND-36）和EuroQual5维度问卷（EQ-5D）中的EuroQual垂直视觉模拟量表（EQ-VAS）进行测量。
■护士\'回答\'不，与SQ相比，患者报告的健康状况恶化与一年前（RAND-36）有关，和较低的感知整体健康(EQ-VAS)。医师\'回答\'不，“不足为奇”与较低的整体健康水平和较低的身体机能有关。患者报告的疼痛，一般健康,疲劳,情感和社会方面与对SQ的反应无关。
■研究结果表明，SQ确定了血液透析患者报告整体健康和身体机能低下。然而,SQ没有确定报告疼痛的患者，情绪问题,或疲劳，这也是在确定重病对话需求时需要考虑的重要方面，症状管理,并能够整合姑息治疗方法。
■探讨护士和医师对SQ的反应如何与患者自我报告的HRQoL相关。
■横断面研究。
■总共，包括282例血液透析患者。
■一名护士和一名医生对每位患者的SQ做出反应。患者报告的HRQoL使用RAND36项健康调查1.0（RAND-36）和EuroQual5维度问卷（EQ-5D）中的EuroQual垂直视觉模拟量表（EQ-VAS）进行测量。
■护士\'回答\'不，与SQ相比，患者报告的健康状况恶化与一年前（RAND-36）有关，和较低的感知整体健康(EQ-VAS)。医师\'回答\'不，“不足为奇”与较低的整体健康水平和较低的身体机能有关。患者报告的疼痛，一般健康,疲劳,情感和社会方面与对SQ的反应无关。
■研究结果表明，SQ确定了血液透析患者报告整体健康和身体机能低下。然而,SQ没有确定报告疼痛的患者，情绪问题,或疲劳，这也是在确定重病对话需求时需要考虑的重要方面，症状管理,并能够整合姑息治疗方法。
