What determines the quality of life of terminally ill cancer patients from their own perspective?

Background: Although several instruments have been developed to measure the quality of life (QOL) of palliative care patients, a rigorous research study has not specifically asked patients themselves what is important to their QOL. It is, therefore, not clear whether these instruments measure what is most important to these patients' QOL. Purpose: To understand the primary determinants of the QOL of palliative care patients with cancer. Method: The study used a qualitative paradigm. Participants were interviewed concerning what was important to their QOL A systematic content analysis of the transcripts was carried out by all the investigators. Results: Five broad domains were found to be important determinants of patient QOL: (1) the patient's own state, including physical and cognitive functioning, psychological state, and physical condition; (2) quality of palliative care; (3) physical environment; (4) relationships; and (5) outlook. Conclusions: Existing instruments cover many of these domains, but no single instrument includes all of the relevant content. The McGill Quality of Life Questionnaire, which we developed previously, has been revised based on these data.