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Quality of life change and response shift in patients admitted to palliative care units: a pilot study

Department of Nursing Home Medicine, Institute for Research in Extramural Medicine, VU Medical Centre, Amsterdam; Department of Public and Occupational Health, Institute for Research in Extramural Medicine, VU University Medical Centre, Amsterdam; Department of Medical Psychology and Psychotherapy and Department of Medical Oncology, Erasmus Medical Centre, Rotterdam

Luc Deliens

Department of Public and Occupational Health, Institute for Research in Extramural Medicine, VU University Medical Centre, Amsterdam; Department of Medical Sociology and Health Sciences, End-of-Life Care Research Group, Vrije Universiteit Brussel, Brussels

Marcel E Ooms

Miel W Ribbe

Department of Nursing Home Medicine, Institute for Research in Extramural Medicine, VU Medical Centre, Amsterdam

Gerrit van der Wal

Department of Public and Occupational Health, Institute for Research in Extramural Medicine, VU University Medical Centre, Amsterdam

This pilot study was carried out to determine to what extent patients admitted to palliative care units (PCUs) in The Netherlands maintained good levels of individual quality of life (QoL), and to what extent response shift - a measure of adaptation - influenced QoL at the end of life. Two components of response shift were measured: reconceptualization (exchanging important areas of life) and value change (changing the perceived importance of important areas of life). Twenty patients admitted to PCUs were interviewed at one week, three weeks, and five weeks after admission. Results show that individual QoL was high and remained stable over the three measurement points. The individual QoL of patients who did not reconceptualize or did not change values was higher than the individual QoL of patients who did. The current pilot data need to be corroborated with data from additional respondents.

Key Words: palliative care • quality of life • response shift

Palliative Medicine, Vol. 19, No. 5, 381-388 (2005)
DOI: 10.1191/0269216305pm1029oa


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