title: Quality of life assessment in advanced cancer patients treated at home, an inpatient unit, and a day care center.
abstract: OBJECTIVE
  To assess quality of life (QoL) in cancer patients treated at home, at an in-patient palliative care unit (PCU), and at a day care center (DCC).
  
  
  METHODS
  QoL was assessed in advanced cancer patients at baseline and after 7 days of symptomatic treatment using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Core 15-Palliative Care (EORTC QLQ-C15-PAL), the Edmonton Symptom Assessment System (ESAS), and the Karnofsky Performance Status (KPS) scale.
  
  
  RESULTS
  A total of 129 patients completed the study, with 51 patients treated at home, 51 patients treated at the PCU, and 27 patients at DCC. In the EORTC QLQ-C15-PAL, improvement in functional and symptom scales was observed except in physical functioning and fatigue levels; patients at DCC had a better physical functioning, global QoL, appetite, and fatigue levels. In the ESAS, improvement in all items was found except for drowsiness levels, which was stable in patients treated at DCC and deteriorated in home and PCU patients. Higher activity, better appetite and well-being, and less drowsiness were observed in patients treated at DCC. KPS was better in DCC patients compared to those treated at home and at the PCU; the latter group deteriorated.
  
  
  CONCLUSIONS
  QoL improved in all patient groups, with better results in DCC patients and similar scores in those staying at home and at the PCU. Along with clinical assessment, baseline age, KPS, physical and emotional functioning may be considered when assigning patients to care at a DCC, PCU, or at home.
authors.affiliation: Department of Palliative Medicine, Poznan University of Medical Sciences, Poznan, Poland.
authors.forename: Wojciech
authors.initials: W
authors.lastname: Leppert
authors.affiliation: Department of Quality of Life Research, Gdansk Medical University, Gdansk, Poland.
authors.forename: Mikolaj
authors.initials: M
authors.lastname: Majkowicz
authors.affiliation: Department of Palliative Medicine, Poznan University of Medical Sciences, Poznan, Poland.
authors.forename: Maria
authors.initials: M
authors.lastname: Forycka
authors.affiliation: Palliative Care Nursing Department, Wroclaw Medical University, Wroclaw, Poland.
authors.forename: Eleonora
authors.initials: E
authors.lastname: Mess
authors.affiliation: Department of Quality of Life Research, Gdansk Medical University, Gdansk, Poland.
authors.forename: Agata
authors.initials: A
authors.lastname: Zdun-Ryzewska
keywords: advanced cancer; oncology; palliative care; patient care; performance status; quality of life