Geriatrics and Gerontology

Biography

Biography: Anne M. Wilkinson

Abstract

Background. We piloted the Quality of Life at the End of Life (QUAL-E) in Australian palliative care in-patients (N=52) and demonstrated feasibility, acceptability and face validity. An unexpected finding was the potential for the QUAL-E to prompt psycho-social-spiritual discussion when conducted as an interview.Aims.We compared a 17-item QUAL-E-Cancer (QUAL-EC) to the Distress Thermometer Screening Tool (DT) and participants’ experience with the QUAL-EC interview.Methods. A cross-sectional, mixed methods design was used. Convenience sampling recruited patients (N=50) with advanced cancer and a prognosis of less than 12 months from a tertiary hospital. Participants completed the DT, followed by the QUAL-EC which was digitally recorded as an interview. Findings. Correlational and thematic analysis found that 39.6% of participants reported severe distress (score ≥7) while 40% reported moderate distress (score 4-6) on the DT. Levels of distress significantly correlated with two QUAL-EC domains: symptom control (r=0.52, p<0.001) and preparation for end of life (r=0.32, p<0.05). Qualitative analysis identified six themes: the health care team; family issues; approaching death; worry;coping and QUAL-EC experience.Feasibility: completion of the QUAL-EC ranged from 3-14 minutes (M=7.37 minutes, SD 3.05 minutes). Acceptability: Participants overwhelmingly found the questions to be clear and did not find the questions hard to understand, hard to answer or stressful. Conclusion.When distress is identified on screening, the QUAL-EC offers good potential for nuanced, versus vague, assessment of globalized distress (e.g., DT) as an aid in targeting patient-centered clinical/psycho-social interventions