ABSTRACT
OBJECTIVES: To provide information about the value of quality of life (QOL) assessments to improve clinical care. DATA SOURCES: Published articles, web resources, clinical practice. CONCLUSION: Clinical assessment of QOL can lead to improved patient outcomes and provide a means of evaluating the effectiveness of interventions. IMPLICATIONS FOR NURSING PRACTICE: QOL assessment provides nurses with a more holistic view of the patient and improves communication between the patient and health care providers.
Subject(s)
Clinical Competence , Nursing Assessment/methods , Oncology Nursing/methods , Quality of Life , Communication , Evidence-Based Nursing , Holistic Health , Humans , Neoplasms/nursing , Neoplasms/psychology , Nurse's Role , Nurse-Patient Relations , Nursing Research , Outcome Assessment, Health Care , Quality of Life/psychology , Surveys and QuestionnairesABSTRACT
Quality-of-life (QOL) instruments used in clinical research can provide important evidence to inform decisions about alternative treatments. This is particularly true when patients, such as those with cancer who are contemplating toxic chemotherapy, face tradeoffs between quantity of life and QOL or when the primary goal of therapy is to improve how patients feel. Surrogate measures (cardiac function, exercise capacity, bone density, tumor size) are inadequate substitutes for direct measurement of QOL. Quality-of-life measures will be most valuable when they comprehensively measure aspects of QOL that are both important to patients and likely to be influenced by therapy, when the QOL measurement instruments are valid (measuring what is intended) and responsive (able to detect all important changes, even if small), and when the results are readily interpretable (determining whether treatment-related changes are trivial, small but important, or large). Researchers are finding new, imaginative ways to help clinicians understand the magnitude of treatment impact on QOL. Additionally, QOL measures may be useful in clinical practice. Recent results from well-designed randomized controlled trials suggest that information on patient QOL provided to clinicians might, in some circumstances, result in benefits for these patients. Further investigation is warranted to confirm these observations and to define the particular combination of methods and settings most likely to yield important benefits.
Subject(s)
Quality of Life , Therapeutics , Decision Making , Humans , Models, Psychological , Patient Care/methods , Patients/psychology , Randomized Controlled Trials as Topic , ResearchABSTRACT
PURPOSE/OBJECTIVES: To describe issues to be considered when measuring the quality of life (QOL) of patients with cancer. DATA SOURCES: Published articles and books, conference proceedings, and abstracts. DATA SYNTHESIS: A review of the existing literature reveals an emerging field of research and considerable discussion of measurement issues. Consensus is growing about measurement approaches to this subjective concept; however, agreement differs regarding specific aspects of measurement approaches and interpretation of data. CONCLUSIONS: The purpose of the QOL assessment and how the data will be analyzed are the main determinants of the choice of assessment and measurement approaches. Differences regarding how QOL is measured may be encountered based on a clinical or research purpose. IMPLICATIONS FOR NURSING: QOL assessments may be used as part of data collection to address a specific research question or may be used to guide clinical practice. Research findings used to guide clinical practice should be evaluated for validity, reliability, and fit of the sample before being incorporated into clinical practice. QOL assessment in clinical practice may be used as an exploratory tool to identify potential problems or may be used to evaluate the effectiveness of a targeted intervention.
