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

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Abstract

Objectives

This study was conducted to explore symptoms, other quality of life (QoL) aspects and impact of age, gender, marital status, cancer diagnosis and time of survival in patients with advanced cancer admitted to palliative care.

Patients and methods

A cross-sectional study of 278 cancer patients completing the European Organization for Research and Treatment of Cancer (EORTC) QLQ-C30 at referral to palliative care.

Main results

Gynaecological and gastro-intestinal tract cancers were the most common. Mean age was 67 years; 62% were female. Median survival was 43 days and 39% lived less than 30 days. Patients reported impaired general QoL and high occurrence of symptoms (44 and 100% for diarrhoea and fatigue, respectively). Fatigue, appetite loss and dyspnoea were reported as most severe (mean values of 80, 59 and 51, respectively, 0–100 scales). Married/cohabiting patients and younger patients reported lower functional abilities and more symptoms. No impact of diagnoses on QoL parameters was found. Patients closest to death did not differ significantly from those with longer time to live in social functioning.

Conclusion

Young and married patients may be at higher risk for perceived low quality of life at the end of life. EORTC QLQ-C30 could be used as a clinical tool for screening of symptoms and reduced functioning in palliative care, but may not be appropriate for use in the most severely ill patients. Limitations of the instrument and the need for robust measurements of patient mix are discussed. Proxy ratings of physical symptoms and nurse responsibility to include QoL assessment in daily practice would increase attrition and decrease selection bias.

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Acknowledgements

This study was supported by grants from Stockholm County Council, Swedish Society of Nursing, Karolinska Institutet, Stockholms Sjukhem Foundation and Swedish Cancer Society. The authors thank Erik Onelöf at Radiumhemmet, Karolinska University Hospital, Stockholm, for help with statistical analysis, Assoc. Prof. Carol Tishelman and Prof. Peter Strang have contributed with valuable and generous discussions and advice.

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Authors and Affiliations

  1. Research & Development Unit, Stockholms Sjukhem Foundation, Mariebergsgatan 22, 112 35, Stockholm, Sweden

    C. Lundh Hagelin, Åke Seiger & C. J. Fürst

  2. Department of Oncology–Pathology, Karolinska Institutet, Stockholm, Sweden

    C. Lundh Hagelin & C. J. Fürst

  3. Neurotec Department, Karolinska Institutet, Stockholm, Sweden

    Åke Seiger

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  1. C. Lundh Hagelin
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Correspondence to C. Lundh Hagelin.

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Lundh Hagelin, C., Seiger, Å. & Fürst, C.J. Quality of life in terminal care—with special reference to age, gender and marital status. Support Care Cancer 14, 320–328 (2006). https://doi.org/10.1007/s00520-005-0886-4

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  • DOI: https://doi.org/10.1007/s00520-005-0886-4

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