Quality of life among patients receiving palliative care in South Africa and Uganda: a multi-centred study

Simple item page
dc.contributor.authorSelman, Lucyen_ZA
dc.contributor.authorHigginson, Ireneen_ZA
dc.contributor.authorAgupio, Godfreyen_ZA
dc.contributor.authorDinat, Natalyaen_ZA
dc.contributor.authorDowning, Juliaen_ZA
dc.contributor.authorGwyther, Lizen_ZA
dc.contributor.authorMashao, Thandien_ZA
dc.contributor.authorMmoledi, Keletsoen_ZA
dc.contributor.authorMoll, Tonyen_ZA
dc.contributor.authorSebuyira, Lydiaen_ZA
dc.contributor.authorIkin, Barbaraen_ZA
dc.contributor.authorHarding, Richarden_ZA
dc.date.accessioned2015-10-28T07:09:21Z
dc.date.available2015-10-28T07:09:21Z
dc.date.issued2011en_ZA
dc.description.abstractBACKGROUND:Quality of life (QOL) is a core outcome of palliative care, yet in African settings there is a lack of evidence on patients' levels of QOL. We aimed to describe QOL among patients with incurable, progressive disease receiving palliative care in South Africa and Uganda, to compare QOL in cancer and HIV, to determine how domains of QOL correlate with overall QOL, and compare levels of QOL in this population with those in other studies using the same tool. METHODS: A cross-sectional survey was conducted using the Missoula Vitas Quality of Life Index (MVQOLI), a 26-item QOL questionnaire with five subscales (Function, Symptom, Interpersonal, Well being, Transcendent) covering physical, social, psychological and spiritual domains and one global QOL item. One item in each subscale assesses the subjective importance of the domain on a score from 1 (least important) to 5 (most important), used to weight the contribution of the subscale towards the Total QOL score. The tool was translated into 6 languages and administered to consecutively recruited patients at four facilities in South Africa and one in Uganda. RESULTS: 285 patients were recruited, with a mean age of 40.1; 197 (69.1%) were female. Patients' primary diagnoses were HIV (80.7%), cancer (17.9%) and other conditions (1.4%). The mean global QOL score was 2.81 (possible range 0 (worst) to 5 (best)); mean Total score 17.32 (possible range 0 to 30). Patients scored most poorly on Function (mean 0.21), followed by Well being (2.59), Symptoms (5.38), Transcendent (5.50), Interpersonal (9.53) (possible range for subscale scores -30 to 30). Most important to patients were: close relationships (mean 4.13), feeling at peace (4.12), sense of meaning in life (4.10), being active (3.84), physical comfort (2.58). Cancer patients were predominantly recruited at three of the sites; hence comparison with HIV-infected patients was restricted to these sites. HIV+ patients (n = 115) scored significantly worse than cancer patients (n = 50) on Well being (Z = -2.778, p = 0.005), Transcendence (Z = -2.693, p = 0.007) and Total QOL (Z = -2.564, p = 0.01). Global QOL score was most weakly correlated with Total QOL (r = 0.37) and the Transcendent subscale was most highly correlated (r = 0.77) (both p < 0.001). Patients receiving palliative care in South Africa and Uganda exhibited significantly poorer QOL compared to similar populations in the USA. CONCLUSIONS: Feeling at peace and having a sense of meaning in life were more important to patients than being active or physical comfort, and spiritual wellbeing correlated most highly with overall QOL. It is therefore vital to identify and meet the psychological and spiritual care needs of patients, as well as to assess and treat pain and other symptoms. Our finding that patients scored most poorly on the Function domain warrants further research.en_ZA
dc.identifier.apacitationSelman, L., Higginson, I., Agupio, G., Dinat, N., Downing, J., Gwyther, L., ... Harding, R. (2011). Quality of life among patients receiving palliative care in South Africa and Uganda: a multi-centred study. <i>Health and Quality of Life Outcomes</i>, http://hdl.handle.net/11427/14487en_ZA
dc.identifier.chicagocitationSelman, Lucy, Irene Higginson, Godfrey Agupio, Natalya Dinat, Julia Downing, Liz Gwyther, Thandi Mashao, et al "Quality of life among patients receiving palliative care in South Africa and Uganda: a multi-centred study." <i>Health and Quality of Life Outcomes</i> (2011) http://hdl.handle.net/11427/14487en_ZA
dc.identifier.citationSelman, L. E., Higginson, I. J., Agupio, G., Dinat, N., Downing, J., Gwyther, L., ... & Harding, R. (2011). Quality of life among patients receiving palliative care in South Africa and Uganda: a multi-centred study. Health Qual Life Outcomes, 9(1), 21.en_ZA
dc.identifier.ris TY - Journal Article AU - Selman, Lucy AU - Higginson, Irene AU - Agupio, Godfrey AU - Dinat, Natalya AU - Downing, Julia AU - Gwyther, Liz AU - Mashao, Thandi AU - Mmoledi, Keletso AU - Moll, Tony AU - Sebuyira, Lydia AU - Ikin, Barbara AU - Harding, Richard AB - BACKGROUND:Quality of life (QOL) is a core outcome of palliative care, yet in African settings there is a lack of evidence on patients' levels of QOL. We aimed to describe QOL among patients with incurable, progressive disease receiving palliative care in South Africa and Uganda, to compare QOL in cancer and HIV, to determine how domains of QOL correlate with overall QOL, and compare levels of QOL in this population with those in other studies using the same tool. METHODS: A cross-sectional survey was conducted using the Missoula Vitas Quality of Life Index (MVQOLI), a 26-item QOL questionnaire with five subscales (Function, Symptom, Interpersonal, Well being, Transcendent) covering physical, social, psychological and spiritual domains and one global QOL item. One item in each subscale assesses the subjective importance of the domain on a score from 1 (least important) to 5 (most important), used to weight the contribution of the subscale towards the Total QOL score. The tool was translated into 6 languages and administered to consecutively recruited patients at four facilities in South Africa and one in Uganda. RESULTS: 285 patients were recruited, with a mean age of 40.1; 197 (69.1%) were female. Patients' primary diagnoses were HIV (80.7%), cancer (17.9%) and other conditions (1.4%). The mean global QOL score was 2.81 (possible range 0 (worst) to 5 (best)); mean Total score 17.32 (possible range 0 to 30). Patients scored most poorly on Function (mean 0.21), followed by Well being (2.59), Symptoms (5.38), Transcendent (5.50), Interpersonal (9.53) (possible range for subscale scores -30 to 30). Most important to patients were: close relationships (mean 4.13), feeling at peace (4.12), sense of meaning in life (4.10), being active (3.84), physical comfort (2.58). Cancer patients were predominantly recruited at three of the sites; hence comparison with HIV-infected patients was restricted to these sites. HIV+ patients (n = 115) scored significantly worse than cancer patients (n = 50) on Well being (Z = -2.778, p = 0.005), Transcendence (Z = -2.693, p = 0.007) and Total QOL (Z = -2.564, p = 0.01). Global QOL score was most weakly correlated with Total QOL (r = 0.37) and the Transcendent subscale was most highly correlated (r = 0.77) (both p < 0.001). Patients receiving palliative care in South Africa and Uganda exhibited significantly poorer QOL compared to similar populations in the USA. CONCLUSIONS: Feeling at peace and having a sense of meaning in life were more important to patients than being active or physical comfort, and spiritual wellbeing correlated most highly with overall QOL. It is therefore vital to identify and meet the psychological and spiritual care needs of patients, as well as to assess and treat pain and other symptoms. Our finding that patients scored most poorly on the Function domain warrants further research. DA - 2011 DB - OpenUCT DO - 10.1186/1477-7525-9-21 DP - University of Cape Town J1 - Health and Quality of Life Outcomes LK - https://open.uct.ac.za PB - University of Cape Town PY - 2011 T1 - Quality of life among patients receiving palliative care in South Africa and Uganda: a multi-centred study TI - Quality of life among patients receiving palliative care in South Africa and Uganda: a multi-centred study UR - http://hdl.handle.net/11427/14487 ER - en_ZA
dc.identifier.urihttp://hdl.handle.net/11427/14487
dc.identifier.urihttp://dx.doi.org/10.1186/1477-7525-9-21
dc.identifier.vancouvercitationSelman L, Higginson I, Agupio G, Dinat N, Downing J, Gwyther L, et al. Quality of life among patients receiving palliative care in South Africa and Uganda: a multi-centred study. Health and Quality of Life Outcomes. 2011; http://hdl.handle.net/11427/14487.en_ZA
dc.language.isoengen_ZA
dc.publisherBioMed Central Ltden_ZA
dc.publisher.departmentDepartment of Public Health and Family Medicineen_ZA
dc.publisher.facultyFaculty of Health Sciencesen_ZA
dc.publisher.institutionUniversity of Cape Town
dc.rightsThis is an Open Access article distributed under the terms of the Creative Commons Attribution Licenseen_ZA
dc.rights.holder2011 Selman et al; licensee BioMed Central Ltd.en_ZA
dc.rights.urihttp://creativecommons.org/licenses/by/2.0en_ZA
dc.sourceHealth and Quality of Life Outcomesen_ZA
dc.source.urihttp://hqlo.biomedcentral.com/en_ZA
dc.subject.otherQuality of Lifeen_ZA
dc.subject.otherPalliative Careen_ZA
dc.subject.otherQualitative Researchen_ZA
dc.titleQuality of life among patients receiving palliative care in South Africa and Uganda: a multi-centred studyen_ZA
dc.typeJournal Articleen_ZA
uct.type.filetypeText
uct.type.filetypeImage
uct.type.publicationResearchen_ZA
uct.type.resourceArticleen_ZA
Files
Original bundle
Now showing 1 - 1 of 1
Thumbnail Image
Name:
Selman_Quality_of_life_palliative_care_2011.pdf
Size:
326.75 KB
Format:
Adobe Portable Document Format
Description:
Download
Collections
Journal Articles