Commentary on Jocham HR, Dassen T, Widdershoven G & Halfens R (2006) Quality of life in palliative care cancer patients: a literature review. Journal of Clinical Nursing 15, 1188–1195

Abstract

Quality of life emerged as a social concept in the second half of the twentieth century in response to increasing affluence in western countries (Fallowfield 1990). It has gained considerable currency in relation to the assessments of health and is usually used to broaden outcomes beyond the medical domain. There remains considerable debate about the domains that underpin the concept of quality of life with the following often included: disease- and treatment-related symptoms, physical functioning, psychological well-being, cognitive functioning, social, spiritual, occupational, economic and environmental factors (Bowling 2001, Fitzsimmons & Ahmedzai 2004). Quality of life is now widely used to explain the rationale for service provision in palliative care although there is no indication that the term was used in the early stages of hospice development (Clark et al. 2005). From a twenty-first century stance, it seems self-evident that the quality of life should be central to the agenda of palliative care services in European countries and this literature review (Jocham et al. 2006) should be welcomed. However, I am going to argue that this literature review (Jocham et al. 2006) is deeply flawed and that readers need to be cautious in drawing any inferences from it. My argument is based around a number of serious inadequacies in the conceptualization, design and conduct of this literature review. Namely, I will highlight three main concerns: • The confounding of quality of life with the quality of care in the introduction and background; • Problems with the methodology and conduct of the literature review which have served to exclude those electronic databases, which are most likely to contain papers of relevance to the quality of life in palliative care; • This has led the authors to fail to identify the most wellknown and established European measures of quality of life and to fail to mention any measures of quality of care.