Quality of Life

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Quality of Life
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Patients evaluation of quality of life

• Provides understanding of impact of illness from
  patients viewpoint
• Different from health status or physical
  functioning
• Quality of life can be good even with physical
  disability
• More than health problems, loss of abilities, or
  functional deficits
• Incorporation of patients values sets QOL
  assessment apart from measures of health status

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Patients evaluation of quality of life

• Important tool for understanding individual
  differences in response to illness
• Individual responses in adapting to cancer and
  treatment
• Re-evaluation of life in context of
  life-threatening disease
• Ultimate purpose for QOL assessment ? Enhanced
  well-being
• Particularly in palliative care and at end of
  life (interventions aimed at providing comfort
  and emotional support)
• Maximize QOL

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Ferrans Model of QOL (1985 1990) Scope of the
Concept
Health andFunctioning Domain
Social and Economic Domain
Quality of Life
Psychological/Spiritual Domain
Family Domain
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Ferrans Powers Quality of Life Index

• Part 1 SATISFACTION with various aspects of
  life
• Part 2 IMPORTANCE of those same aspects of
  life
• Scores reflect satisfaction with the aspects of
  life that are valued by the individual.
• Five Scores
• Overall QOL
• Health and functioning
• Psychological/spiritual
• Social and economic
• Family

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Ferrans Powers Quality of Life Index

• Published first in 1985 (200 published studies)
• International research (30 countries)
• Americas USA, Canada, Mexico, Brazil, Chile
• Europe Denmark, France, Great Britain,
  Hungarian, Italy, Lithuania, Norway, Poland,
  Portugal, Romania, Russia, Spain, Sweden
• Middle East Israel, Jordan, Turkey
• Africa South Africa
• Asia India, China, Korea, Japan, Thailand,
  Taiwan
• Australia and New Zealand
• U.S. cross-cultural research
• African Americans
• Mexican Americans
• Korean Americans

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21 Languages

• Norwegian
• Polish
• Portuguese
• Romanian
• Russian
• Spanish
• Swedish
• Tamil
• Thai
• Turkish

• Arabic
• Chinese
• Danish
• English
• French
• Hebrew
• Hungarian
• Italian
• Japanese
• Korean
• Lithuanian

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Ferrans Powers Quality of Life Index
-- Prognostic value in 251 breast cancer
patients (p .0006)
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Quality of Life of African American Cancer
Survivors
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Quality of Life of African American Cancer
SurvivorsNIH R01 CA89418 (CALGB 119901)

• Survivors 500 African American cancer survivors
  
• Breast, prostate, colon
• Currently free of cancer
• Controls 500 African American non-cancer
  controls
• Selected via random digit dialing from the areas
  in which the cancer survivors reside.
• Matched (as a group) to the survivor group on
  age, gender, health insurance status, and
  education level

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16 Participating CALGB Institutions

• Heme/Onc Associates of Central NY
• Northern Indiana
• Ohio State University
• University of Chicago
• University of Illinois at Chicago
• Wake Forest
• Walter Reed
• Washington University St. Louis
• Hartford Hospital

• Jersey Shore Medical Center 
• Navy Medical Center San Diego
• Queens Hospital Medical Center
• Roswell Park Cancer Center
• Sibley Memorial Hospital
• Wayne Memorial Hospital - SCCC
• Jesse Brown VA Medical Center

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Distribution of Participating Institutions
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Explaining the Variance in Quality of Life
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2
.2
3
5
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26
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22
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Model explained 66 of variance in QOL
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