title: Suitability of quality-of-life outcome measures in palliative care in the South African setting.
abstract: OBJECTIVE
  Quality of life (QoL) is a multidimensional, subjective, and highly individual phenomenon. The current study speaks to the QoL domains identified by palliative patients living in Africa. The need to identify these domains has been recognized but seemed to still be lacking. This study filled this knowledge gap by providing the domains and by giving directions in terms of the assessment of QoL in palliative patients living in resource-restricted communities in South Africa.
  
  
  METHODS
  We followed a multi-method approach and conducted a literature review to identify and describe the multidimensional QoL instruments used in African palliative care. A secondary analysis design and open-coding method was employed to identify the domains influencing the QoL of palliative patients living in a resource-restricted South African community, after which we compared these domains to the domains assessed by the identified QoL instruments.
  
  
  RESULTS
  We found that two multidimensional QoL of life instruments-the Missoula-Vitas Quality of Life Index (MVQoLI) and the Functional Assessments of Chronic Illness Therapy-Palliative Care (FACIT-Pal)-have been used in African palliative care and have identified various domains, grouped as four themes: physical concerns, psychosocial issues, financial restraints, and existential issues. The patient-identified QoL domains were to a great extent not assessed by the MVQoLI and FACIT-Pal.
  
  
  CONCLUSIONS
  Our study highlights the complexity of QoL and QoL assessment. A more accurate representation of the QoL of palliative patients living in resource-restricted communities might be obtained by using individualized measures or exploring what QoL means to these patients and selecting QoL instruments accordingly.
authors: Department of Nursing Education,Faculty of Health Sciences,University of the Witwatersrand,Johannesburg,Republic of South Africa.
authors: Johanna E
authors: JE
authors: Maree
authors: Adelaide Tambo School of Nursing Science,Tshwane University of Technology,Pretoria,Republic of South Africa.
authors: Jacoba J M Jansen
authors: JJ
authors: Van Rensburg
mesh_terms: D000328:Adult; D000368:Aged; D002908:Chronic Disease / Q000523:psychology / Q000628:therapy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010166:Palliative Care / Q000523:psychology*; D063868:Patient Outcome Assessment; D011594:Psychometrics / Q000295:instrumentation; D036301:Qualitative Research; D011788:Quality of Life / Q000523:psychology*; D013019:South Africa
keywords: Africa; Functional Assessments of Chronic Illness Therapy–Palliative Care (FACIT–Pal); Missoula–Vitas Quality of Life Index (MVQoLI); Multidimensional QoL instruments; Resource-poor settings