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Assessment of palliative need in patients with chronic kidney disease by the new Three Levels of Need Questionnaire (3LNQ) is not exhaustive

Line Blindbæk1, Birthe Thørring2 & Lars Ehlers1

17. feb. 2014
2 min.


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).


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.


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 from 19-89%, whereas the prevalence of unmet needs ranged from 11% to 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).


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 (SPC) for these patients is needed in order to help them optimally.


Not relevant.


Not relevant.

CORRESPONDENCE: Line Blindbæk. E-mail:

CONFLICTS OF INTEREST: Disclosure forms provided by the authors are available with the full text of this article at

REFERENCE: Dan Med J 2014;61(4):A4806