The concept of quality of life of dying persons in the context of health care

Considerable research has addressed quality of life and quality of care; ho wever, it has not addressed adequately the experiences of patients and thei r families at the end of life. Health care may have a greater effect on qua lity of life during the dying process than it normally does. Building on re search and expert review, a conceptual framework is presented that specifie s and integrates quality of life and quality of health care indicators. Fiv e main concepts include patient/family context, structure of care, process of care, satisfaction with care, and quality and length of life. Patient an d family perspectives are considered. The framework emphasizes quality of l ife, thus detailed definitions of each quality of life domain are provided. The goal is to facilitate development of a comprehensive set of measures t o describe the quality of life of dying persons and evaluate the care they receive, to be used to improve end-of-life care. J Pain Symptom Manage 1999 ;17:93-108. (C) U.S. Cancer Pain Relief Committee, 1999.