Quality of Life Assessments in Clinical Practice

doi:10.1016/j.soncn.2009.11.003

Seminars in Oncology Nursing

Volume 26, Issue 1, February 2010, Pages 12-17

https://doi.org/10.1016/j.soncn.2009.11.003 Get rights and content

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.

Section snippets

Value of QOL Research for Evidence-Based Practice

Evidence-based practice is the use of published research findings as a guide to the choice of approaches to patient care. Studies demonstrating the efficacy of nursing interventions provide the most directly applicable guidance for evidence-based practice. For example, Salonen et al¹ tested a telephone support intervention with 228 patients with breast cancer 1 week after surgery (approximately half had mastectomy and half had breast-conserving surgery). Two weeks later, those who received the

Value of Assessing QOL in Routine Clinical Practice

A new trend in oncology is the assessment of QOL as a part of routine clinical practice to guide care in an individualized manner. These assessments can be useful for planning care, choosing interventions, aiding in informed decision-making, and promoting care that will generate better outcomes.4, 5 Table 2 lists some of the pros and cons of the clinical assessment of QOL. Several studies have shown the benefits of measuring QOL in the course of routine practice.6, 7, 8 The patients provided

Single-Item QOL Questions

The gold standard for QOL assessment is the use of a published instrument (questionnaire) that has well-established reliability and validity. However, some investment of resources from the clinic is normally required for routine administration and to provide rapid scoring so that the results can be made available immediately. But there is another option for nurses who would like to incorporate QOL assessment immediately into their clinical practice. The assessment of QOL in a clinical setting

Conclusion

According to a recent report from the National Academy of Science, “Cancer care today often provides state-of-the-science biomedical treatment, but fails to address the psychological and social (psychosocial) problems associated with the illness. This failure can compromise the effectiveness of health care and thereby adversely affect the health of cancer patients.”²² The use of individual assessments of QOL and PROs in clinical practice provides a means to address this problem and promote

Claudette G. Varricchio, RN, DSN, FAAN: Varricchio Consulting, Wakefield, RI.

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Cited by (25)

Delirium: Cognitive, Functionality, and Quality of Life Outcomes in Critically Ill Patients
2023, Revista Colombiana de Psiquiatria
There is scarce evidence of the impact of delirium on the post-ICU outcomes of critically ill patients. This study assessed the effect of delirium on cognitive function, functionality, and quality of life after three months from discharge in critically ill patients.
A nested case–control study was realized from April to September 2018. The prevalence of delirium and its association with mortality was assessed, and the alterations in cognition, functionality, and quality of life in survivors of critical illness three months after discharge from the ICU.
81 patients were included and evaluated with the CAM-ICU; 43 were defined as cases. The prevalence of delirium was 26%, and the mortality of patients with and without delirium was 35.4% vs. 10%, respectively. In the follow-up, the delirium group showed lower scores in the MMSE (p < 0.01), with a specific decline in the subdomains of orientation, calculation, and language/praxis compared with the control group. The delirium group showed a decreased score in the SF-36, with a significant decline in social function, emotional role, and mental health (p < 0.05). There were no differences observed in functionality measured by the PGC-IADL.
Education strategies are required to increase delirium awareness in ICU teams. Support from a mental health interdisciplinary team is needed to guide the preventive and rehabilitation interventions for post-ICU patients.
Existe evidencia limitada acerca del impacto del delirium en los desenlaces post-UCI de los pacientes críticamente enfermos. Este estudio evalúo el impacto del delirium en la función cognitiva, funcionalidad y la calidad de vida después de tres meses del egreso en pacientes críticamente enfermos.
Un estudio de casos y controles anidado fue realizado entre abril y septiembre de 2018. La prevalencia de delirium y su asociación con la mortalidad fue evaluada y las alteraciones en la cognición, funcionalidad y la calidad de vida de sobrevivientes de enfermedad crítica a los tres meses de haber egresado de la Unidad de Cuidados Intensivos (UCI).
Ochenta y un pacientes fueron incluidos y evaluados con el Confusion Assessment Method for the Intensive Care Unit (CAM-ICU); 43 fueron definidos como casos. La prevalencia de delirium fue de 26%, y la mortalidad de los pacientes con y sin delirium fue de 35,4 vs. 10%, respectivamente. Durante el seguimiento, el grupo de delirium mostró peores puntajes en el Mini-mental State Examination (MMSE) (p < 0,01), con un deterioro específico en los subdominios de orientación, cálculo y lenguaje/praxia comparada con el grupo control. El grupo de delirium también evidenció un peor desempeño en el 36-Item Short Form Health Survey questionnaire (SF-36), con una disminución significativa de la función social, rol emocional y la salud mental (p < 0,05). No se observaron diferencias significativas en la funcionalidad a través del Philadelphia Geriatric Center-Instrumental Activities of Daily Living (PGC-IADL).
Se requieren estrategias educativas para incrementar la conciencia sobre el delirium en los equipos de UCI y se necesita del apoyo de un equipo interdisciplinario en salud mental para guiar las intervenciones de prevención y rehabilitación en los pacientes post-UCI.
Welfare, Quality of Life, and Euthanasia of Aged Horses
2016, Veterinary Clinics of North America - Equine Practice
Citation Excerpt :
This approach would be readily transferable to veterinary medicine, and an owner-perceived QoL assessment method has been reported for use in dogs.57 In clinical settings, a rapid evaluation comprising a short series of single-item questions can be used to provide valid QoL assessment, allowing identification of individuals with poor QoL requiring further evaluation.36 Together with a thorough veterinary examination, asking owners to identify QoL domains that they consider to be important for their geriatric horse could be a useful way to inform a tailored, single-item question format, assessment for rating and monitoring QoL in that individual.
Quality of Life With Urinary Diversion
2010, European Urology, Supplements
Citation Excerpt :
We must therefore spare a thought for the patient who is asked to make an informed decision about which transposed intestinal segment surgical option to choose. QoL may be measured in clinical practice for several reasons: to assess the impact of a disease or condition on QoL, to assess the impact of a medical or surgical intervention on QoL, to profile a population, to assess the relationship between QoL and prognosis or health outcome, to improve communication, to screen for risk, to identify preferences, to train new staff, and for use in clinical audit and in clinical governance [10–12]. The measurement of QoL is useful for clinical practice beyond research purposes [12].
There continues to be debate about how best to replace bladder function following radical cystectomy. All the usual options currently involve the use of transposed intestinal segments, and all have advantages and disadvantages. The impact of each option on quality of life (QoL) is an important consideration.
This review assesses the evidence base that underpins each of the major forms of transposed intestinal segment surgery (ileal conduit diversion, continent urinary diversion, and orthotopic bladder replacement). The meaning, determinants, and measurement of QoL are also explored. We conducted a systematic review searching Medline, PubMed, EMBASE, CINAHL, and the Cochrane Library from 1966 to August 2010. A total of 46 studies (including 8 prospective studies) met the inclusion criteria reporting on 4186 patients. Although the reports suggest a reasonably well-maintained QoL after all transposed intestinal segment surgical options, most were retrospective studies, and the few prospective nonrandomised studies had limitations.
From the available published evidence, it still remains unclear if one form of transposed intestinal segment surgery is superior to another in terms of QoL. In light of this continued uncertainty, there is an urgent need to establish the important determinants of QoL for this cohort; to standardise a set of core important outcomes; and, once and for all, to undertake high-quality prospective (ideally randomised) studies comparing the different surgical options to help guide policy and clinical practice in transposed intestinal segment surgical practice. Until such time, care will continue to be individualised, taking into account patient factors, surgeon factors, centre factors, and health provider factors, unsatisfactory as this may be for patients.
Quality of life and satisfaction with care among palliative cancer patients in Saudi Arabia
2016, Palliative and Supportive Care
Residents' self-reported quality of life in long-term care facilities in Canada
2015, Canadian Journal on Aging
Objective assessment of chronic pain in horses using the horse chronic pain scale (Hcps): A scale-construction study
2021, Animals

View all citing articles on Scopus

Claudette G. Varricchio, RN, DSN, FAAN: Varricchio Consulting, Wakefield, RI.

Carol Estwing Ferrans, PhD, RN, FAAN: Professor and Associate Dean for Research, University of Illinois at Chicago, College of Nursing, Chicago, IL.

View full text

Quality of Life Assessments in Clinical Practice

Objectives

Data Sources

Conclusion

Implications for Nursing Practice

Section snippets

Value of QOL Research for Evidence-Based Practice

Value of Assessing QOL in Routine Clinical Practice

Single-Item QOL Questions

Conclusion

Gynecol Oncol

Lung Cancer

J Pain Symptom Manage

Mayo Clin Proc

Mayo Clin Proc

Mayo Clin Proc

Mayo Clin Proc

Mayo Clin Proc

Telephone intervention and quality of life in patients with breast cancer

Cancer Nurs

Symptom experiences and quality of life of rural and urban older adult cancer survivors

Cancer Nurs

Variability of patterns of fatigue and quality of life over time based on different breast cancer adjuvant chemotherapy regimens

Oncol Nurs Forum