The quality of life of patients with cancer receiving hospice care.

Abstract

PURPOSE/OBJECTIVES: To evaluate the outcomes of hospice services and explore factors that affect the quality of life (QOL) of patients with cancer receiving hospice care. DESIGN: Descriptive. SETTING: Two homecare hospices in the southeastern United States. SAMPLE: Convenience sample of 118 hospice patients with a diagnosis of cancer and their primary caregivers. METHODS: The Hospice Quality of Life Index (HQLI) was administered to patients and caregivers within 48 hours of admission and after three weeks of hospice care. MAIN RESEARCH VARIABLE: QOL. FINDINGS: HQLI scores could range from a low of 25 to a high of 250. Mean HQLI scores of the patients ranged from 168-173.7; the caregivers' means ranged from 157-158. Factor analysis confirmed four subscales: physical/functional, social/spiritual, psychological, and financial well-being. The social/spiritual subscale resulted in the highest mean scores (74.9), and the physical/functional subscale had the lowest (23.9). Correlations between patient and caregiver HQLI scores were only moderate (r = 0.51-0.55) CONCLUSIONS: Overall QOL remained stable during the study period when measured by an apparently valid and reliable instrument. QOL is characterized by multidimensionality and subjectivity. IMPLICATIONS FOR NURSING PRACTICE: Nurses need to design interventions to support the QOL of people who are terminally ill, with a particular focus on the physical/functional aspects of care. QOL assessment data should be collected from patients whenever possible, and outcomes of care should continue to be studied using valid and reliable tools.