The applicability of quality-of-life assessment in palliative care: comparing two quality-of-life measures

Two self-administered quality-of-life measures, the McGill Quality of Life Questionnaire (MQOL) and the Patient Evaluated Problem Scores (PEPS) were c ompared in patients receiving palliative care. The MQOL is a multidimension al questionnaire consisting of 16 items in five quality-of-life (QOL) domai ns: physical symptoms, physical well-being, psychological, existential and support domains. The PEPS is an individualized questionnaire asking patient s to identify and rate major problems affecting their QOL. Both questionnai res were completed by 36 patients during outpatient clinic visits in three palliative care settings in Wales. Of those patients who stated their quest ionnaire preference 60% favoured MQOL due to its comprehensiveness, while o thers (28%) preferred PEPS due to its simplicity The MQOL showed excellent internal consistency (alpha = 0.90). The intrapatient analysis of answers f rom both questionnaires showed that MQOL was better than PEPS in reporting physical symptoms and support domain, while PEPS detected more psychosocial issues. The MQOL overall QOL score correlated highly with its existential domain (r(s) = 0.57, P < 0.0005) and the PEPS overall quality of life (r(s) = 0.77, P < 0.0005). Similarly, the PEPS overall QOL correlated well with MQOL total score (r(s) = 0.76, P < 0.0005) and existential domain of the MQ OL (r(s) = 0.63, P < 0.0005). The findings support the importance of an exi stential domain in assessing the QOL of this population. Both MQOL and PEPS were found to be relevant and acceptable in advanced cancer patients recei ving palliative care. However, with its favourable psychometric properties MQOL may be more suitable for QOL assessment in this population.