ABSTRACT
Objective: This paper aims to present a comprehensive literature review of Quality of Life (QOL) in patients who are suffering from serious medical illness as evidenced by receiving treatment in the intensive care setting. By examining the instruments used to measure QOL, as well as the factors that influence it, this review will explore the relevance of QOL to patient care and management. Data Sources: From Medline and other online resources, over 467 articles were identified, of which 73 articles were selected for inclusion in this review by three independent reviewers. The reviewers reached a consensus using pre-defined selection criteria. Study Selection Criteria: Articles had to: 1) be written in English or have an available published English translation, 2) be published in a peer-reviewed journal, 3) study adult humans, 4) focus on serious medical illnesses, such as sepsis and MI (myocardial infarction), rather than focusing exclusively on terminal illnesses (any study design was accepted), and 5) use at least one QOL measure. Data Extraction: The study selection process yielded 73 articles. Research methodology and key findings were derived from the full text and tables of the selected studies. Data Synthesis: QOL is very poor in gravely ill medical patients and continues to decline with further deterioration of medical status. A model that incorporates QOL and the severity of the medical illness, in addition to the patient’s wishes, might have the potential to improve overall QOL for patients and their families and guide end-of-life decisions. Conclusions: A formal assessment of the patient's QOL and final wishes could assist the patient, their loved ones, and the treating physician in making critical decisions about how to improve QOL through comfort/palliative care.
ABSTRACT
Aims: To review the relevant literature on Quality of Life (QOL) impairment in PTSD and the impact of treatment interventions on QOL. Methods: A database search from 1980-2012 was conducted using Medline, PsycINFO, and the PILOTS database using the keywords: “PTSD”, “posttraumatic stress disorder”, “stress disorders”, “quality of life”, “QOL”, and “health-related quality of life.” Two reviewers applied pre-defined selection criteria independently and reached a consensus on the inclusion of 37 studies that focused on QOL in PTSD. The impact of PTSD interventions on QOL was analyzed. Results: The findings revealed that QOL is gravely impaired in PTSD populations, such as veterans, refugees, survivors of terrorist attacks, natural disaster survivors, rescue personnel, and survivors of violence. Research shows that PTSD is an independent predictor of QOL impairment and that various psychotherapeutic and pharmacological treatment modalities might potentially improve QOL in PTSD. However, their ability to improve QOL up to community norm levels is unclear. Conclusion: QOL is seriously compromised in patients suffering from PTSD. It would be important to include QOL as an outcome measure in PTSD clinical and research work in order to identify the PTSD treatments that best improve QOL in different populations.