Understanding the effects of cancer on the quality of life of affected patients is critical to clinical research as well as to optimal management and care.
Methods
Nine instruments for assessing quality of life in patients with cancer are identified, and their effectiveness during palliative care is analyzed.
Results
Most of the instruments included physical, functional, and symptom control, as well as psychologic and social aspects. Financial and spiritual aspects were included less often. While all but two of the instruments had adequate validity and reliability data published, only two - the Spitzer Quality-of-Life Index and the Hospice Quality-of-Life Index - were designed and validated for palliative care populations.
Conclusions
Although a variety of instruments is currently available, none is ideal for all palliative care settings. Further development and refinement of instruments are needed.
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References
1.
JohnsonJ.R., TempleR.Food and Drug Administration requirements for approval of new anticancer drugs. Cancer Treatment Rep.1985; 69: 1155–1159.
2.
CellaD.F.Measuring quality of life in palliative care. Semin Oncol.1995; 22(2 Suppl 3): 73–81.
3.
CoatesA., GebskiV., BishopJ.F.Improving the quality of life during chemotherapy for advanced breast cancer: a comparison of intermittent and continuous treatment strategies. N Engl J Med.1987; 317: 1490–1495.
4.
HopwoodP.Progress, problems and priorities in quality of life research. Eur J Cancer.1992; 28A: 1748–1752.
5.
SpiroS.G., SouhamiR.L., AshC.M.Randomized trial of planned versus as required chemotherapy in small cell lung carcinoma (SCLC). Fifth World Conference on Lung Cancer. Lung Cancer.1989; 4(Suppl): A101, 6.1.05.
6.
TannockI.F., BoydN.F., DeBoerG.A randomized trial of two dose levels of cyclophosphamide, methotrexate, and fluorouracil chemotherapy for patients with metastatic breast cancer. J Clin Oncol.1988; 6: 1377–1387.
7.
KarnofskyD.A., AbelmannW.H., CraverL.F.The use of the nitrogen mustards in the palliative treatment of carcinoma. Cancer.1948; 1: 634–656.
8.
ZubrodC.G., SchneidermanM., FreiE.Appraisal of methods for the study of chemotherapy of cancer in man: comparative therapeutic trial of nitrogen mustard and triethylene thiophosphoramide. J Chron Dis.1960; 11: 703.
9.
Frank-StrombergM.Single instruments for measuring quality of life. In: Frank-StrombergM., ed. Instruments for Clinical Nursing Research.Norwalk, Conn: Appleton & Lange; 1988.
10.
GanzP.A., HaskellC.M., FiglinR.A.Estimating the quality of life in a clinical trial of patients with metastatic lung cancer using the Karnofsky performance status and the Functional Living Index-Cancer. Cancer.1988; 61: 849–856.
11.
FerransC.E., PowersM.J.Quality of Life Index: development and psychometric properties. Adv Nurs Sci.1985; 8: 15–24.
12.
McMillanS.C., MahonM.A study of quality of life of hospice patients on admission and at week 3. Cancer Nurs.1994; 17: 52–60.
13.
McMillanS.C., MahonM.Measuring quality of life in hospice patients using a newly developed Hospice Quality of Life Index. Qual Life Res.1994; 3: 437–447.
14.
McMillanS.C.Quality of life of hospice patients with cancer as reported by patients and caregivers. Oncol Nurs Forum.1996. In press.
15.
McWhinneyI.R., BassM.J., DonnerA.Evaluation of a palliative care service: problems and pitfalls. Br Med J.1994; 309: 1340–1342.
16.
DonovanK., Sanson-FisherR.W., RedmanS.Measuring quality of life in cancer patients. J Clin Oncol.1989; 7: 959–968.
17.
JenningsB.M., MuhlenkampB.Systematic misperceptions: oncology patients’ self-reported affective states and their caregivers’ perceptions. Cancer Nurs.1981; 4: 485–489.
18.
KaneR.L., KleinS.J., BernsteinL.Hospice role in alleviating the emotional stress of terminal patients and their families. Med Care.1985; 23: 189–197.
19.
MorrisJ.N., SherwoodS.Quality of life of cancer patients at different stages in the disease trajectory. J Chron Dis.1987; 40: 545–556.
20.
WellischD.Work, social, recreation, family, and physical status. Cancer.1984; 53: 2290.
21.
SchipperH., LevittM.Measuring quality of life: risks and benefits. Cancer Treat Rep.1985; 69: 1115–1125.
22.
SpitzerW.O., DobsonA.J., HallJ.Measuring the quality of life of cancer patients. J Chron Dis.1981; 34: 585–597.
23.
Addington-HallJ.M., MacDonaldL.D., AndersonH.R.Can the Spitzer Quality of Life Index help to reduce prognostic uncertainty in terminal care?Br J Cancer.1990; 62: 695–699.
24.
PriestmanT.J., BaumM.Evaluation of quality of life in patients receiving treatment for advanced breast cancer. Lancet.1976; 899–901.
25.
McGowanI., BarrH., KrasnerN.Palliative laser therapy for inoperable rectal cancer: does it work?Cancer.1989; 63: 967–969.
26.
SchipperH., ClinchJ., McMurrayA.Measuring the quality of life of cancer patients: the Functional Living Index-Cancer. Development and validation. J Clin Oncol.1984; 2: 472–483.
27.
FinkelsteinD.M., CassilethB.R., BonomiP.D.A pilot study of the Functional Living Index-Cancer (FLIC) scale for the assessment of quality of life for metastatic lung cancer patients. Am J Clin Oncol.1988; 11: 630–633.
28.
PadillaG.V., PresantC., GrantM.M.Quality of Life Index for patients with cancer. Res Nurs Health.1983; 83: 117–126.
29.
PadillaG.V., GrantM.M.Quality of life as a cancer nursing outcome variable. Adv Nurs Sci.1985; 8: 45–60.
30.
RyanL.Quality of life and lung or colon cancer: a prospective study to determine the impact of an experimental treatment. Presented at the Tenth Annual Oncology Nursing Society Congress, May 1985, Houston, Texas.
31.
FerransC.E.Development of a Quality of Life Index for patients with cancer. Oncol Nurs Forum.1990; 17(Suppl 3): 15–21.
CellaD.F., TulskyD.S., GrayG.The Functional Assessment of Cancer Therapy Scale: development and validation of the general measure. J Clin Oncol.1993; 11: 570–579.
34.
AaronsonN.K., AhmedzaiS., BergmanB.The European patients with cancer. Oncol Nurs Forum QLQ-C30: a quality of life instrument for use in international clinical trials in oncology. J Natl Cancer Inst.1993; 85: 365–376.
