Jeanette M. Wallin, Stefan H. Jacobson, Lena Axelsson, Jenny Lindberg, Carina I. Persson, Jenny Stenberg, Agneta Wennman-Larsen
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The aim was to explore nurses' and physicians' responses to the SQ regarding patients on hemodialysis, and to investigate how these answers were associated with patient clinical characteristics.</p>\n </section>\n \n <section>\n \n <h3> Methods</h3>\n \n <p>This comparative cross-sectional study included 361 patients for whom 112 nurses and 15 physicians responded to the SQ regarding 6 and 12 months. Patient characteristics, performance status, and comorbidities were obtained. Cohen's kappa was used to analyze the interrater agreement between nurses and physicians in their responses to the SQ and multivariable logistic regression was applied to reveal the independent association to patient clinical characteristics.</p>\n </section>\n \n <section>\n \n <h3> Findings</h3>\n \n <p>Proportions of nurses and physicians responding to the SQ with “no, not surprised” was similar regarding 6 and 12 months. However, there was a substantial difference concerning which specific patient the nurses and physicians responded “no, not surprised”, within 6 (<i>κ</i> = 0.366, <i>p</i> < 0.001, 95% CI = 0.288–0.474) and 12 months (<i>κ</i> = 0.379, <i>p</i> < 0.001, 95% CI = 0.281–0.477). There were also differences in the patient clinical characteristics associated with nurses' and physicians' responses to the SQ.</p>\n </section>\n \n <section>\n \n <h3> Discussion</h3>\n \n <p>Nurses and physicians have different perspectives in their appraisal when responding to the SQ for patients on hemodialysis. 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Discrepancy in responses to the surprise question between hemodialysis nurses and physicians, with focus on patient clinical characteristics: A comparative study
Introduction
The surprise question (SQ) “Would I be surprised if this patient died within the next xx months” can be used by different professions to foresee the need of serious illness conversations in patients approaching end of life. However, little is known about the different perspectives of nurses and physicians in responses to the SQ and factors influencing their appraisals. The aim was to explore nurses' and physicians' responses to the SQ regarding patients on hemodialysis, and to investigate how these answers were associated with patient clinical characteristics.
Methods
This comparative cross-sectional study included 361 patients for whom 112 nurses and 15 physicians responded to the SQ regarding 6 and 12 months. Patient characteristics, performance status, and comorbidities were obtained. Cohen's kappa was used to analyze the interrater agreement between nurses and physicians in their responses to the SQ and multivariable logistic regression was applied to reveal the independent association to patient clinical characteristics.
Findings
Proportions of nurses and physicians responding to the SQ with “no, not surprised” was similar regarding 6 and 12 months. However, there was a substantial difference concerning which specific patient the nurses and physicians responded “no, not surprised”, within 6 (κ = 0.366, p < 0.001, 95% CI = 0.288–0.474) and 12 months (κ = 0.379, p < 0.001, 95% CI = 0.281–0.477). There were also differences in the patient clinical characteristics associated with nurses' and physicians' responses to the SQ.
Discussion
Nurses and physicians have different perspectives in their appraisal when responding to the SQ for patients on hemodialysis. This may reinforce the need for communication and discussion between nurses and physicians to identify the need of serious illness conversations in patients approaching the end of life, in order to adapt hemodialysis care to patient preferences and needs.
期刊介绍：
Accounts of Chemical Research presents short, concise and critical articles offering easy-to-read overviews of basic research and applications in all areas of chemistry and biochemistry. These short reviews focus on research from the author’s own laboratory and are designed to teach the reader about a research project. In addition, Accounts of Chemical Research publishes commentaries that give an informed opinion on a current research problem. Special Issues online are devoted to a single topic of unusual activity and significance.
Accounts of Chemical Research replaces the traditional article abstract with an article "Conspectus." These entries synopsize the research affording the reader a closer look at the content and significance of an article. Through this provision of a more detailed description of the article contents, the Conspectus enhances the article's discoverability by search engines and the exposure for the research.
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