Description

The Quality of Life Questionnaire in End Stage Patients (QLQESP-30) is an assessment instrument designed to evaluate quality of life among patients in the terminal stage of cancer.

The questionnaire adopts a multidimensional approach to quality of life, considering several areas of patients’ everyday experience and functioning. These include activities, self-care, health status, support, communication, and psychological functioning.

This multidimensional assessment provides information about different aspects of quality of life that may be particularly relevant to patients receiving palliative care.

Objective

The primary objective of the QLQESP-30 is to assess quality of life among patients with terminal-stage cancer.

The instrument is intended to provide information about the specific areas of life that may be affected during the advanced stages of cancer and to facilitate a broader assessment of patients’ experiences and needs.

Structure and Dimensions

According to the available source, the QLQESP-30 comprises six main multi-item subscales associated with important aspects of quality of life.

The areas addressed include:

Activities: Assesses aspects related to the patient’s ability to engage in activities.

Self-Care: Examines the patient’s capacity to manage personal care and everyday needs.

Health Status: Addresses aspects related to the patient’s general health condition.

Support: Evaluates aspects of the support available to or perceived by the patient.

Communication: Examines communication-related aspects of the patient’s experience.

Psychological Functioning: Addresses psychological and emotional aspects associated with the patient’s condition.

The questionnaire also includes a qualitative item and a separate item assessing overall quality of life.

Scoring

For the main questionnaire items, participants select the response that best reflects their assessment using a 3-point response scale:

1 = Yes
2 = Maybe
3 = No

An exception is the qualitative item included within the treatment subscale. For this item, patients are asked to identify the reasons they consider most important when selecting an appropriate treatment and rank them from:

1 = Most important to 5 = Least important.

Overall quality of life is assessed separately using an 11-point Likert scale ranging from 0 to 10, where:

0 = Very poor
10 = Excellent

Score Interpretation

The direction of scoring differs between the individual quality-of-life subscales and the overall quality-of-life item.

For the individual subscales, higher scores indicate a poorer or less favorable response.

In contrast, for the overall quality-of-life item, higher scores indicate better perceived quality of life.

This difference in scoring direction should be considered when analyzing and interpreting the questionnaire results.

Validity

According to the available source, the validity of the instrument has been examined using four approaches:

  • Comparisons with the ECOG general performance status scale
  • Factor analysis
  • Criterion-related validity
  • Correlations with two other quality-of-life questionnaires

The two quality-of-life instruments identified in the source are the Assessment of Quality of Life in Palliative Care Instrument (AQEL) and the European Organisation for Research and Treatment of Cancer Core Quality of Life Questionnaire (QLQ-C30).

These approaches were used to investigate whether the questionnaire adequately reflects relevant dimensions of quality of life among terminal cancer patients.

Reliability

According to the source document, the questionnaire’s subscales demonstrated internal consistency coefficients ≥ 0.70, both before and during palliative treatment.

Test-retest reliability was also examined. The source reports that the Spearman’s rho correlation coefficient was satisfactory and statistically significant (p < 0.05).

These findings support the consistency of the questionnaire within the population described in the source.

Statistical Analysis and Data Use

QLQESP-30 results can be examined at both the individual subscale level and the overall quality-of-life level.

The subscale scores can provide information about specific areas of patients’ experiences, while the overall quality-of-life item provides a broader subjective evaluation.

When repeated assessments are available, scores may also be examined before and during palliative treatment to evaluate changes in different dimensions of quality of life.

Because the scoring direction differs between the subscales and the overall quality-of-life item, this distinction should be maintained throughout statistical analysis and interpretation.

Applications

The QLQESP-30 can be applied in clinical and research contexts involving terminal cancer patients, particularly when assessing quality of life in relation to palliative care.

Its multidimensional structure allows different aspects of patients’ experiences to be examined rather than relying exclusively on a single global assessment of quality of life.

The information obtained can contribute to a broader understanding of patients’ activities, self-care, health status, support, communication, psychological functioning, and overall perceived quality of life.

References

Mystakidou K, Tsilika E, Kouloulias V, Parpa E, Katsouda E, Kouvaris J, Vlahos L. The “Palliative Care Quality of Life Instrument (PQLI)” in terminal cancer patients. Health and Quality of Life Outcomes. 2004;2(1):1-13.