title: Assessment of palliative need in patients with chronic kidney disease by the new Three Levels of Need Questionnaire (3LNQ) is not exhaustive.
abstract: BACKGROUND
  The purpose of the study was to test and evaluate the Three Levels of Needs Questionnaire (3LNQ) as a method to clarify if help is needed and provided for 12 palliative problems in patients with chronic kidney disease stage 4 (CKD4).
  
  
  METHODS
  A total of 33 patients from a consecutive sample of patients with CKD4 were given two questionnaires. The 3LNQ measures problem intensity and unmet needs for 12 palliative problems. An open question was added allowing the patients to describe additional symptoms not included in the 3LNQ. The EuroQol 5-Dimensional 3-Level Questionnaire was distributed in order to determine the patients' health-related quality of life.
  
  
  RESULTS
  A total of 27 patients returned the two questionnaires (81.8%). Their average age was 69.3 years (range: 49-82 years). The prevalence of the 12 palliative problems ranged 19-89%, whereas the prevalence of unmet needs ranged 11-44%. The patients reported a median of seven problems and two unmet needs. Besides the 12 problems addressed by the 3LNQ, the following problems were mentioned by the patients: arthritis in the feet, morning cough, muscle cramps/pain, and nightly urination. The patients' mean health-related quality of life score was estimated to 0.791 (interval: 0.564-1).
  
  
  CONCLUSIONS
  The 3LNQ is usable to indicate problem intensity and unmet needs in patients with chronic kidney disease stage 4. However, the questionnaire does not cover all the problems from which patients with chronic kidney disease suffer. Further research into the complexity of need of specialised palliative care for these patients is needed in order to help them optimally.
  
  
  BACKGROUND
  not relevant.
  
  
  BACKGROUND
  not relevant.
authors.affiliation: Danagården 42, 9230 Svenstrup J, -Denmark. lineblindbaek@gmail.com.
authors.forename: Line
authors.initials: L
authors.lastname: Blindbaek
authors.forename: Birthe
authors.initials: B
authors.lastname: Thørring
authors.forename: Lars
authors.initials: L
authors.lastname: Ehlers
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D020380:Needs Assessment / Q000458:organization & administration; D010166:Palliative Care; D011788:Quality of Life; D051436:Renal Insufficiency, Chronic / Q000628:therapy*; D011795:Surveys and Questionnaires