Quality of life in cancer patients - Use of a revised hospice index

Author(s): Weitzner, M.

Journal/Book: Cancer Pract. 1998; 6: 227 East Washington Sq, Philadelphia, PA 19106. Lippincott-Raven Publ. 282-288.

Abstract: PURPOSE: Improving or maintaining the quality of life for persons with cancer is a major goal of end-of-life care; however, to measure quality-of-life outcomes, a valid and reliable measure is needed. The purpose of this project was to report the psychometric properties of the revised Hospice Quality of Life Index (HQLI) including validity and reliability for hospice patients with cancer. DESCRIPTION: Data were collected from home care hospice patients with cancer (n=255) and a group of apparently healthy adults in the community (n=32). The revised HQLI is a 28-item self-report instrument that includes three subscales: Psychophysiological Well-being, Functional Well-being, and Social/Spiritual Well-being. RESULTS: Evidence for validity was provided in three ways. First, factor analysis confirmed the three subscales (Psychophysiological, Functional, and Social/Spiritual Well-being). Second, a weak significant correlation was found between the Eastern Cooperative Oncology Group Performance Status Rating scores and HQLI scores (r=.26, P=.00). Third, the HQLI was able to discriminate between hospice patients with cancer and apparently healthy adults (lambda = .34, P=.00). In addition, the mean scores of these two groups were significantly different (t=6.64: P= .00). However, only a minimal difference in scores was found on the Social/Spiritual Well-being subscale between the cancer and healthy groups. Reliability for the revised HQLI was high for both the total scale (alpha=.88) and the subscales (alpha= .82-.85). CLINICAL IMPLICATIONS: Emphasis has been placed recently on understanding quality of life from the patients perspective. The development of a valid and reliable tool can guide care givers in providing meaningful quality-of-life issues and to maintain direction over a critical aspect of their care. Of note from this study, the significant difference in social/spiritual well-being suggest that patients are able to appraise their functional abilities realistically and still maintain their social network and spiritual beliefs. Indeed, it may be that patients give family relationships and spiritual beliefs greater focus during a terminal illness.

Note: Article McMillan SC, Univ S Florida, Coll Nursing, Mdc 22, 12901 Bruce B Downs Blvd, Tampa,FL 33612 USA

Keyword(s): cancer pain; hospice; palliative care; quality of life; OF-LIFE; DISEASE

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