TERMINALLY ILL CANCER-PATIENTS - THEIR MOST IMPORTANT CONCERNS

PURPOSE: When the goal of treatment is palliative, the most important outcome is improving patient quality of life. The authors describe the major concerns of terminally ill cancer patients with a prognosis of 6 months or less, OVERVIEW: In phase I of this three-part study, 74 te rminally ill patients were interviewed to identify their major concern s. In phase III interviews with 120 terminally ill cancer patients sho wed that their most important concerns encompass existential, spiritua l, familial, physical, and emotional issues. Phase III will determine the validity and reliability of a quality-of-life scale based on these patients' most important concerns. The information presented here sum marizes the results of interviews from phases I and II. CLINICAL IMPLI CATIONS: Patients were receptive to being interviewed and remarked on the relevance and importance of these issues to their own experience. Several patients commented that although their disease was assessed an d reassessed throughout their care, the existential, spiritual, famili al, and emotional aspects of their illness rarely were a focus of thei r care. Healthcare professionals can create an atmosphere in which the se patients feel comfortable exploring the quality-of-life issues that are most important to them. The systematic assessment of patient conc erns about quality of life may complement disease assessment and facil itate referrals to appropriate members of the healthcare team. The wid e range of concerns reported suggests that a team approach, including physicians, nurses, social workers, psychiatrists, psychologists, and chaplains, is die most effective way to meet tile needs of terminally ill patients.