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Confirmation of the “disability paradox” among hospice patients: Preservation of quality of life despite physical ailments and psychosocial concerns

Published online by Cambridge University Press:  26 February 2004

JEAN S. KUTNER ,
DAVID E. NOWELS ,
CORDT T. KASSNER ,
JANET HOUSER ,
LUCINDA L. BRYANT,  and
DEBORAH S. MAIN
JEAN S. KUTNER
Affiliation:
Division of General Internal Medicine, University of Colorado Health Sciences Center, Denver, Colorado
DAVID E. NOWELS
Affiliation:
Department of Family Medicine, University of Colorado Health Sciences Center, Denver, Colorado
CORDT T. KASSNER
Affiliation:
Division of General Internal Medicine, University of Colorado Health Sciences Center, Denver, Colorado
JANET HOUSER
Affiliation:
Department of Health Services Administration, Regis University, Denver, Colorado
LUCINDA L. BRYANT,
Affiliation:
Center for Health Services Research, University of Colorado Health Sciences Center, Denver, Colorado
DEBORAH S. MAIN
Affiliation:
Department of Family Medicine, University of Colorado Health Sciences Center, Denver, Colorado Colorado Health Outcomes Program, University of Colorado Health Sciences Center, Denver, Colorado
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Abstract

Objective: The purpose of this study was to describe quality of life (QOL) and psychosocial and spiritual issues among patients receiving hospice care.

Methods: A questionnaire addressing QOL, spirituality, optimism, loss, fears about the terminal process and death anxiety was administered to 66 adults receiving care from 14 hospices. The physical components of QOL (physical symptoms and physical well-being) were rated lower than the psychosocial and spiritual aspects (support, existential well-being, psychological symptoms).

Results: Respondents had a strong spiritual connection and a strong sense of hope. Although these individuals did not express anxiety or fear about death, there were concerns about the dying process itself. Also, although most felt at ease with their current situation, respondents were concerned about how their illness was affecting their family. Financial and legal issues did not concern most of these individuals.

Significance of results: There were few significant associations between patient characteristics and the QOL or other psychosocial or spiritual issues addressed. Among this older terminally ill population receiving hospice care, whose functional status was fair and for whom physical symptoms were troublesome, QOL persisted and a positive outlook prevailed.

Keywords

Quality of lifeHospicePalliative careSpiritualityPsychological stress
Type
Research Article
Information
Palliative & Supportive Care , Volume 1 , Issue 3 , September 2003 , pp. 231 - 237
Copyright
© 2003 Cambridge University Press

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