Quality of Life of Palliative Care Patients in the Last Two Weeks of Life

Abstract

Quality of life (QOL) is the main consideration in caring for advanced cancer patients, yet little is known about the QOL in the terminal phase. We profiled the QOL of 58 advanced cancer patients during their last 2 weeks of life using the McGill QOL questionnaire-Hong Kong version. The patients provided ratings of QOL an average of 5.6 (median 6) days pre-death. Palliative care services were successful in maintaining the total QOL score during the dying phase. The mean score was 7.0 of 10. Among the various domains, the physical and existential domains scored relatively poorly at 5.9 and 6 of 10, respectively. The worst physical symptom and meaning of life were the individual items with the poorest scores (4.8 and 5.4 of 10, respectively). Compared with admission, there was statistically significant improvement in the worst physical symptom (P = 0.02) and eating item (P = 0.002), but deterioration in physical well-being (P = 0.03), meaning of existence (P = 0.007), and satisfaction with oneself (P = 0.04). In conclusion, QOL evaluation during the terminal phase identifies important aspects requiring improvement during the last two weeks of life. Physical and existential domains of dying cancer patients needed more attention.

Health-related quality of life during the last three months of life in patients with advanced cancer

“…The levels of impairment and symptoms found are consistent with those from other studies on cancer patients at the end of life [29,32]. However, most previous studies were either cross-sectional studies, in which the patients were followed for a short period of time, or they presented longitudinal data from cohorts of patients varying at subsequent assessments due to drop-out or death [20,21,32]. Adequate comparisons are therefore difficult, and to our knowledge, this is one of the first studies describing how a large number of cancer patients perceive their HRQL over time at the end of life.…”

Symptoms, treatment and “dying peacefully” in terminally ill cancer patients: a prospective study

“…a high prevalence of fatigue, ADL dependency and feeling unwell and an increase in the number and severity of physical symptoms shortly before death have been reported for other cancer patients [10,11,12,15,19,20].…”

Quality of life in terminal care—with special reference to age, gender and marital status

“…Quality of life (QoL) is one of the important patient-focused considerations for management of patients with incurable cancer [12,13,34,40]. Focus on health-related quality of life (HRQL) illustrates an evolution in health care from a concentration on disease-oriented, curative treatments to increased interest in the human experience of illness, particularly in situations where achievement of cure is uncertain or improbable [51].…”