COSMIN database

Assessing physical functioning: a systematic review of quality of life measures developed for use in palliative care

Jordhoy, M. S., Ringdall, G. I., Hellbostad, J. L., Dervoll, L., Loge, J. H., and Kaasa, S.
Background: Physical decline is experienced by all palliative care patients and affects most aspects of life. Physical functioning (PF) is therefore a crucial domain for quality of life (Qol) assessments. The purpose of this study was to review how PF assessments are performed in Qol instruments developed for palliative care Methods: For identification of instruments, Medline searches up to April 2005 were performed using the terms (palliative care OR end of life care OR terminal care) AND quality of life AND (assessment OR instrument OR questionnaire). A total of 1326 hits were screened. Named OoL instruments were extracted from 240 abstracts and 46 relevant reports. Items assessing PF were then identified and classified according to activity domains as described by the WHO International Classification of Functioning Disability and Health. Results: Of 224 different instruments detected, 39 were identified as developed for palliative care. Of these, 11 included original PF assessments. Two were comprehensive performance status measures made for staff assessment, 9 were multidimensional tools including 2-7 PF items. The content and phrasing of items varied considerably. All instruments included some aspects of self-care, whereas the coverage of mobility, domestic, work - and leisure activities was inconsistent. Interpretation: Despite its importance, PF assessment seems to be a minor part of palliative care OoL instruments. Clear definitions and conceptualization of PF are needed, as well as a consensus on relevant aspects to include in improved instruments. Performance scales already developed should be further explored with regard to content, validity and psychometric properties.
<Go to ISI>://WOS:000252463300003
Palliative Medicine
Publication year:
Functional status:
Physical functioning
Overall quality of life:
Overall quality of life
Adults (18-65)
Children (0-18)
Seniors (65+)
Certain conditions originating in the perinatal period and related symptoms
Certain infections and parasitic diseases and related symptoms
Congenital malformations, deformations and chromosomal abnormalities and related symptoms
Diseases of and symptoms related to the blood and blood-forming organs and certain disorders involving the immune mechanism
Diseases of and symptoms related to the circulatory system
Diseases of and symptoms related to the digestive system
Diseases of and symptoms related to the ear and mastoid process
Diseases of and symptoms related to the eye and adnexa
Diseases of and symptoms related to the genitourinary system
Diseases of and symptoms related to the musculoskeletal system and connective tissue
Diseases of and symptoms related to the nervous system
Diseases of and symptoms related to the respiratory system
Diseases of and symptoms related to the skin and subcutaneous tissue
Endocrine, nutritional and metabolic diseases and related symptoms
External causes of morbidity and mortality
Injury, poisoning and certain other consequences of external causes
Neoplasms and related symptoms
Symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified
PRO / non-PRO:
Non-patient Reported Outcome
Patient Reported Outcome
Type of measurement instrument:
1 - Questionnaires
6 - Clinical rating scales
7 - Observations
AQEL - Assessment of Quality of Life at the End of Life
EFAT - Edmonton Functional Assessment Tool
HRCA-QL - Hebrew Rehabilitation Centre for Aged Quality of Life
MQLS - McMaster Quality of Life Scale
MVQOLI - Missoula-VITAS Quality of Life Index
PNPC (Also: PNPC-sv) - Problems and needs in Palliative Care Questionnaire (Also: PNPC-sv - short version)
PPS - Palliative Performance Scale
PQLI - Palliative Care Quality of Life Questionnaire
RAI - Resident Assessment Instrument (ALSO RAI-PC - Resident Assessment Instrument for Palliative Care)
SQI - Spitzer Quality of Life Index (alias: SQLI; SQL)
TIQ - The Therapy Impact Questionnaire