title: Assessing physical functioning: a systematic review of quality of life measures developed for use in palliative care.
abstract: BACKGROUND
  Physical decline is experienced by all palliative care patients and affects most aspects of life. Physical functioning (PF) is therefore a crucial domain for quality of life (Qol) assessments. The purpose of this study was to review how PF assessments are performed in Qol instruments developed for palliative care
  
  
  METHODS
  For identification of instruments, Medline searches up to April 2005 were performed using the terms (palliative care OR end of life care OR terminal care) AND quality of life AND (assessment OR instrument OR questionnaire). A total of 1326 hits were screened. Named QoL instruments were extracted from 240 abstracts and 46 relevant reports. Items assessing PF were then identified and classified according to activity domains as described by the WHO International Classification of Functioning Disability and Health.
  
  
  RESULTS
  Of 224 different instruments detected, 39 were identified as developed for palliative care. Of these, 11 included original PF assessments. Two were comprehensive performance status measures made for staff assessment, 9 were multidimensional tools including 2-7 PF items. The content and phrasing of items varied considerably. All instruments included some aspects of self-care, whereas the coverage of mobility, domestic, work--and leisure activities was inconsistent.
  
  
  CONCLUSIONS
  Despite its importance, PF assessment seems to be a minor part of palliative care QoL instruments. Clear definitions and conceptualization of PF are needed, as well as a consensus on relevant aspects to include in improved instruments. Performance scales already developed should be further explored with regard to content, validity and psychometric properties.
authors: Department of Cancer Research and Molecular Medicine, Faculty of Medicine, Norwegian University of Science and Technology (NTNU), Trondheim, Norway. mjordhoy@online.no
authors: Marit S
authors: MS
authors: Jordhoy
authors: Gerd
authors: G
authors: Inger Ringdal
authors: Jorunn L
authors: JL
authors: Helbostad
authors: Line
authors: L
authors: Oldervoll
authors: Jon Håvard
authors: JH
authors: Loge
authors: Stein
authors: S
authors: Kaasa
mesh_terms: D000203:Activities of Daily Living; D006304:Health Status; D006801:Humans; D017063:Outcome Assessment, Health Care / Q000458:organization & administration* / Q000592:standards; D010166:Palliative Care / Q000458:organization & administration* / Q000592:standards; D011788:Quality of Life; D011795:Surveys and Questionnaires