Measuring Patient-Oriented Outcomes in Palliative Care: Functionality and Quality of Life

Abstract

Outcomes measurement is necessary to evaluate quality of care, increase knowledge about experiences with cancer and therapies, and determine the effectiveness of interventions directed toward improving symptoms and quality of life (QOL) in research and clinical care. Recent attention on outcomes measurement and research in palliative care settings has emphasized the need to incorporate patient-reported outcomes. Unlike other areas of research in oncology, palliative care research is comprised largely of descriptive studies elucidating the process involved with palliative care, with a notable void in well-designed patient-oriented studies employing standard instruments for measuring functional status, QOL, symptoms, and psychosocial well-being. Outcomes programs in practice settings where palliative care is an integral part of clinical services can offer important information about patient experiences across the continuum of care and help to identify patients most likely to benefit from palliative care interventions. Therefore, oncology nurses must be informed about outcome-measurement issues, including ways to select reliable and valid instruments and determine which ones are appropriate for palliative care populations. Content related to the measurement of patient-oriented outcomes is presented to assist nurses in developing outcomes programs in palliative care settings.

Palliative care quality indicators in Italy. What do we evaluate?

“…Methodological instruments for the identification of other types of outcome are not mentioned. Our analysis confirms the need, already described in international literature [5,9,11,20,21], to develop and implement outcome indicators.…”

“…But the discrepancy between data reported by the patient and those of the medical or nursing staff is all too well known [5,7].…”

“…Recently, palliative care services have grown steadily both in Italy [3] and around the world [4,5], often as a result of increasing interest in this topic by the legislators. Parallel to the growth and to the general public interest, it is becoming necessary to develop a system for monitoring the quality and accuracy of the new services [6].…”

New perspective for nutritional support of cancer patients: Enteral/parenteral nutrition

“…The development of palliative care in terms of recognizing the needs of the dying has becoming a nursing and medical speciality. The involvement of the World Health Organization (WHO) in palliative care and the continuous development of treatment modalities available to cancer patients creates the expectation that outcomes for the patient should also be positively influenced (26,27). Palliative care is focused on maintaining adequate hydration, alleviating or controlling symptoms (e.g., nausea and vomiting) and maintaining body weight and composition.…”

End of Life Care among Head and Neck Cancer Patients

“…1 Moreover, patient and familyoriented strategies to assess efficacy of palliative and end of life care are crucial. 2,3 In addition, telephone surveys of family members of deceased head and neck cancer patients are feasible and provide valuable data. 4 A recently validated survey instrument has been designed to assess the quality of treatment at the end of life based upon the responses of family members of deceased cancer patients.…”