The "Palliative Care Quality of Life Instrument (PQLI)" in terminal cancer patients

BACKGROUND: This paper describes the development of a new quality of life instrument in advanced cancer patients receiving palliative care. METHODS: The Palliative Care Quality of Life Instrument incorporates six multi-item and one single-item scale. The questionnaire was completed at baseline and one-week after. The final sample consisted of 120 patients. RESULTS: The average time required to complete the questionnaire, in both time points, was approximately 8 minutes. All multi-item scales met the minimal standards for reliability (Cronbach's alpha coefficient ≥.70) either before or during palliative treatment. Test-retest reliability in terms of Spearman-rho coefficient was also satisfactory (p < 0.05). Validity was demonstrated by inter-item correlations, comparisons with ECOG performance status, factor analysis, criterion-related validation, and correlations with the Assessment of Quality of Life in Palliative Care Instrument (AQEL), and the European Organisation for Research and Treatment of Cancer (EORTC) Core Quality of Life Questionnaire (QLQ-C30, version 3.0). CONCLUSION: The PQLI is a reliable and valid measure for the assessment of quality of life in patients with advanced stage cancer

Psychological distress of patients with advanced cancer - Influence and contribution of pain severity and pain interference

The growing interest in the psychological distress and the multidimensionality of pain in patients with cancer has been the major reason for the conduction of this study. The aims we; re to evaluate psychological distress and pain in patients with advanced cancer and the impact of pain severity and pain interference dimensions on the anxiety and depression. One hundred twenty patients with advanced cancer were surveyed at a palliative care unit in Athens, Greece. Greek versions of the Hospital Anxiety and Depression (G-HAD) scale and the Brief Pain Inventory were administered. Information concerning patients’ treatment received was acquired from the medical records, whereas physicians recorded their clinical condition. The analysis showed that significant associations were found between pain interference to “mood” and HAD-A (anxiety) (r = 0.252, P =.005) and between pain interference to “relations with other people” and HAD-A (r = 0.474, P &lt;.0005). Multiple regression analyses showed that “average pain” (P &lt;.05), pain interference’to “walking ability” (P &lt;.05), “normal work” (P &lt;.05, and “relations with other people” are significant predictors of HAD-anxiety (HAD-A) (P &lt;.0005), explaining 46.2% of total variance. For depression (HAD-D), the Greek version of the Brief Pain Inventory dimension that serve as predictor is “enjoyment of life,” as well as the demographic variables of “age,” and “gender” (P &lt;.05), explaining 22.2% of variance. Moreover, a further analysis of the pain severity and pain interference scales showed that they differentiate the anxiety of the patients with cancer. In this patient sample, pain interference and, to a lesser extent, pain severity was significantly associated with psychological distress (anxiety and pain), whereas pain interference to “walking ability,” “normal work,” and “relations with other people” was found to be more prominent and troublesome to patients’ anxiety than that to patients’ depression