Factors Impacting Quality of Life at End of Life Identified
(HealthDay News) – Nine factors explain some of the variance in the quality of life (QOL) of patients with advanced cancer in end-of-life (EOL) care.
To identify the main factors that influence QOL at EOL, Baohui Zhang, of the Dana-Farber Cancer Institute in Boston, and associates conducted a multi-site, prospective, longitudinal study involving 396 patients with advanced cancer and their informal caregivers. Participants were followed from enrollment in September 2002–February 2008 to death, a median of 4.1 months later.
While the majority of variance in QOL at EOL was unexplained, the researchers identified a set of nine factors that explained some of the variance. Factors that had a negative effect on QOL included: intensive care unit stays, which explained 4.4% of the variance; hospital deaths (2.7%); patient worry at baseline (2.7%); feeding tube use in the final week (1.1%); and chemotherapy in the final week (0.8%). The following factors had a positive impact on QOL: religious prayer or meditation at baseline (2.5%); pastoral care (1.0%); and patient-physician therapeutic alliance at baseline (0.7%). The site of cancer care explained 1.8% of the variance in QOL.
"By reducing patient worry, encouraging contemplation, integrating pastoral care within medical care, fostering a therapeutic alliance between patient and physician that enables patients to feel dignified, and preventing unnecessary hospitalizations and receipt of life-prolonging care, physicians can enable their patients to live their last days with the highest possible level of comfort and care," the authors write.