title: Determinants of quality of life in patients near the end of life: a longitudinal perspective.
abstract: OBJECTIVE
  to describe the quality of life (QOL) of patients near the end of life and to identify determinants of their QOL.
  
  
  METHODS
  descriptive, longitudinal.
  
  
  METHODS
  university-affiliated cancer center, two private oncologists' offices, and patients' homes.
  
  
  METHODS
  80 patients with either stage IIIb or IV lung cancer newly diagnosed in the previous month or recurrent lung cancer with distant disease.
  
  
  METHODS
  patients were interviewed for responses to instruments to assess demographic, physical, psychosocial, and spiritual characteristics. Baseline data were collected at the patients' places of oncology care. Home visits were made for the two-month and four-month data collection points.
  
  
  METHODS
  QOL; symptom frequency, severity, and distress; functional status; anxiety; depression.
  
  
  RESULTS
  fifty percent of patients died within five months of their lung cancer diagnosis. Patients reported a relatively high QOL that did not change significantly as they approached the end of life. Symptom distress was the strongest determinant of QOL, followed by symptom severity, symptom frequency, and depression.
  
  
  CONCLUSIONS
  QOL was most affected by symptoms experienced in patients with advanced lung cancer, particularly distress associated with symptoms. Interventions for symptom management must be implemented at diagnosis because patients in this population may approach the end of life quickly.
  
  
  CONCLUSIONS
  a routine and thorough symptom assessment is imperative for patients with advanced lung cancer. Attention to symptom distress is important because of its effect on QOL.
authors.affiliation: School of Nursing, University of Louisville, Kentucky, USA. carla.hermann@louisville.edu
authors.forename: Carla P
authors.initials: CP
authors.lastname: Hermann
authors.forename: Stephen W
authors.initials: SW
authors.lastname: Looney
mesh_terms: D000342:Affective Symptoms / Q000451:nursing / Q000523:psychology; D001007:Anxiety / Q000451:nursing / Q000523:psychology; D017281:Cost of Illness; D003863:Depression / Q000451:nursing / Q000523:psychology; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008175:Lung Neoplasms / Q000451:nursing / Q000523:psychology*; D008297:Male; D009730:Nursing Assessment / Q000379:methods; D009859:Oncology Nursing / Q000379:methods*; D017060:Patient Satisfaction; D011788:Quality of Life; D029181:Spirituality; D013727:Terminal Care / Q000523:psychology*