Assessment of activities of daily living and quality of life among palliative care inpatients: A preliminary prospective cohort study

Abstract

Maintaining physical independence is important to terminally ill patients; rehabilitation can improve both functional status and quality of life (QOL) during palliative care. In this prospective pilot study, we evaluated changes in physical function, symptoms, and QOL among 19 hospitalized patients receiving palliative or terminal care for cancer (7 men and 12 women; mean age, 66.8 years, range, 44–84 years). Assessments were performed at admission and after 2 weeks, primarily using the Functional Independence Measure (FIM) and the McGill Quality of Life Questionnaire (MQOL), and a follow-up evaluation was performed 4 weeks after admission if possible. The study was from April to September 2013. In 19 patients, FIM responses were obtained from 17 and 7 patients at 2 and 4 weeks, respectively. MQOL responses were obtained from 11 and 5 patients at 2 and 4 weeks, respectively. A comparison of FIM scores at admission and 2 weeks revealed nonsignificant reductions in the total, motor, and cognitive elements (P = 0.46, 0.70, and 0.20, respectively), which remained nonsignificant at 4 weeks (P = 0.51, 0.65, and 0.27, respectively). There was no significant decline in the total MQOL between admission and 2 and 4 weeks. Although QOL was correlated with physical symptoms, it was not correlated with function. In conclusion, we showed that patient function did not significantly decline and that self-efficacy was maintained with our intervention. A multidisciplinary palliative care approach may reduce symptoms, thereby improving patient QOL. Achieving symptom control is still the mainstay of palliative care.