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Quality of Life

  • Diseases and their treatment have an impact on patient well-being
  • Quality of life (QoL) is a measure of an illness, disease and its treatment on patient welfare
  • Has dimensions beyond physical measures of patients progress
  • No universal definition of QoL exists
  • It has three fundamental characteristics
    • Multidimensional
      • Physical - patients perceived ability to carryout daily activities
      • Social - ability to interact with family and friends
      • Psychological - degrees of depression, anxiety, fear etc
    • Subjective
    • Dynamic

Quality of life assessment

  • QoL assessment is used to
    • Access progress of individual patient
    • In clinical trials to compare treatment options
    • Determine cost-effectiveness of treatment
  • Instrument used must be
    • Valid - measure what it is supposed to measure
    • Reliable - produce consistent results
    • Responsive - be able to detect changes with time
  • Can be either self-administered or by interview
  • Can be repeated on several occasions

Measures of quality of life

  • Data is usually collected using a structured questionnaire
  • Different items tap various dimensions of QoL
  • QoL instruments can be either generic or specific

Generic instruments

  • Assess many dimensions
  • Produce a global concept of QoL
  • Two types of generic questionnaires exist
    • Health profiles (e.g. SF-36)
    • Health indices (e.g. Quality adjusted life years)

Specific instruments

  • Used for specified disease or condition
  • Several types exist
    • Domain specific (e.g. Hospital anxiety and depression scales)
    • Disease specific (e.g. EORTC QLQ-C30 for cancer patients)
    • Population specific (e.g. children or elderly)
    • Symptom specific (e.g. McGill pain questionnaire)

Bibliography

Cella D,  Chang C H,  Lai J S,  Webster K.  Advances in quality of life measurements in oncology patients.  Semin Oncol 2002;  29 (Suppl 8);  60-68.

Conroy T,  Bleiberg H,  Glimelius B.  Quality of life in patients with advanced colorectal cancer;  what has been learnt?  Eur J Cancer 2003;  39:  287-294

 

 
 

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