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Article
Quality of life at the end of life
Health and Quality of Life Outcomes (2007)
  • Paula Diehr, University of Washington
  • Bill Lafferty
Abstract
Background: Little is known about self-perceived quality of life (QOL) near the end of life, because such information is difficult to collect and to interpret. Here, we describe QOL in the weeks near death and determine correlates of QOL over time, with emphasis on accounting for death and missing data. Methods: Data on QOL were collected approximately every week in an ongoing randomized trial involving persons at the end of life. We used these data to describe QOL in the 52 weeks after enrollment in the trial (prospective analysis, N = 115), and also in the 10 weeks just prior to death (retrospective analysis, N = 83). The analysis consisted of graphs and regressions that accounted explicitly for death and imputed missing data. Results: QOL was better than expected until the final 3 weeks of life, when a terminal drop was observed. Gender, race, education, cancer, and baseline health status were not significantly related to the number of “weeks of good-quality life” (WQL) during the study period. Persons younger than 60 had significantly higher WQL than older persons in the prospective analysis, but significantly lower WQL in the retrospective analysis. The retrospective results were somewhat sensitive to the imputation model. Conclusions: In this exploratory study, QOL was better than expected in persons at the end of life, but special interventions may be needed for persons approaching a premature death, and also for the last 3 weeks of life. Our descriptions of the trajectory of QOL at the end of life may help other investigators to plan and analyze future studies of QOL. Methodology for dealing with death and the high amount of missing data in longitudinal studies at the end of life needs further investigation.
Keywords
  • quality of life,
  • longitudinal,
  • death,
  • end of life,
  • missing data
Publication Date
August 3, 2007
Citation Information
Paula Diehr and Bill Lafferty. "Quality of life at the end of life" Health and Quality of Life Outcomes Vol. 5 Iss. 51 (2007)
Available at: http://works.bepress.com/paula_diehr/48/