title: Confirmation of the "disability paradox" among hospice patients: preservation of quality of life despite physical ailments and psychosocial concerns.
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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Division of General Internal Medicine, University of Colorado Health Sciences Center, Denver, CO 80262, USA. Jean.Kutner@uchsc.edu
authors.forename: Jean S
authors.initials: JS
authors.lastname: Kutner
authors.forename: David E
authors.initials: DE
authors.lastname: Nowels
authors.forename: Cordt T
authors.initials: CT
authors.lastname: Kassner
authors.forename: Janet
authors.initials: J
authors.lastname: Houser
authors.forename: Lucinda L
authors.initials: LL
authors.lastname: Bryant
authors.forename: Deborah S
authors.initials: DS
authors.lastname: Main
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003120:Colorado; D003430:Cross-Sectional Studies; D005260:Female; D017051:Hospice Care; D006801:Humans; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D029181:Spirituality; D019452:Terminally Ill / Q000523:psychology*