(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, according to a study published online July 9 in the Archives of Internal Medicine.

To identify the main factors that influence QOL at EOL, Baohui Zhang, of the Dana-Farber Cancer Institute in Boston, and associates conducted a multisite, prospective, longitudinal study involving 396 patients with advanced cancer and their informal caregivers. Participants were followed from enrollment in September 2002 through 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 percent of the variance; hospital deaths (2.7 percent); patient worry at baseline (2.7 percent); feeding tube use in the final week (1.1 percent); and chemotherapy in the final week (0.8 percent). The following factors had a positive impact on QOL: religious prayer or meditation at baseline (2.5 percent); pastoral care (1.0 percent); and patient-physician therapeutic alliance at baseline (0.7 percent). The site of cancer care explained 1.8 percent of the variance in QOL.

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“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.

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