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12 - Assessing health-related quality of life at end of life

Published online by Cambridge University Press:  18 December 2009

By
Betty R. Ferrell Ph.D., F.A.A.N.
Edited by
Joseph Lipscomb ,
Carolyn C. Gotay  and
Claire Snyder
Betty R. Ferrell Ph.D., F.A.A.N.
Affiliation:
Research Scientist City of Hope Medical Center, Duarte, CA
Joseph Lipscomb
Affiliation:
National Cancer Institute, Bethesda, Maryland
Carolyn C. Gotay
Affiliation:
Cancer Research Center, Hawaii
Claire Snyder
Affiliation:
National Cancer Institute, Bethesda, Maryland
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Summary

Assessment of health-related quality of life (HRQOL) at end of life (EOL) can be quite challenging. However, understanding how treatment affects HRQOL during the terminal phases of care is critical to providing the quality of cancer care called for by the National Cancer Policy Board (NCPB) of the Institute of Medicine. The stage at diagnosis, disease progression, and personal and social factors make cancer care at the end of life extraordinarily complex. Inevitably, as one approaches death, symptoms are dynamic and change in an unpredictable fashion, requiring rapid modifications in medications and other therapies. At this time, assessment of HRQOL, as well as patient management, are formidable tasks.

In studying terminally ill populations, it is important to articulate what is meant by palliative and “end of life” care. The World Health Organization (WHO) defines palliative care as the “active total care of patients whose disease is not responsive to curative treatments.” The NCPB has adopted the WHO definition of palliative care, but it also notes that palliative care should begin at the time of cancer diagnosis and extend through the course of the disease to the time of death. While palliative care and EOL care are often seen as equivalent, some make the distinction that EOL care is focused only on the terminal stage, whereas palliative care may extend throughout the disease trajectory. For purposes of this paper, palliative care and EOL care will be used interchangeably, per the WHO definition.

Type
Chapter
Information
Outcomes Assessment in Cancer
Measures, Methods and Applications
 , pp. 264 - 285
Publisher: Cambridge University Press
Print publication year: 2004

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To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

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