Artikel
Quality of life in treatment guidelines and patients care
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Veröffentlicht: | 20. März 2006 |
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Gliederung
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In the early seventies of the last century the concept of quality of life has been taken up in medicine. Within the last decades, its significance in clinical practice and research have grown up documented by the still increasing publication rates per year. To distinguish between QoL in its more general sense and the requirements of clinical medicine and research the term "health related quality of life" (HRQoL) has been created. HRQoL is defined as a subjective, multi-dimensional and dynamic concept, primarily assessed by the rating of the patients. The most common dimensions are physical symptoms, role functions, psychological wellbeing and social relationship. Meanwhile there is a wide range of instruments available which allow standardized measurement of HRQoL in different areas. In oncology HRQoL is used not only as a primary or secondary endpoint in clinical trials, but also as a process characteristic to identify and assess patients needs for additional treatment or symptom control. Against this background HRQoL has been integrated in the development of guidelines for treating cancer patients. In the evidence based guidelines (S3) for diagnosis and treatment of breast cancer quality of life is included as an important criterium which has to be considered in all treatment decisions especially in palliative care. The presentation is reviewing the recent developments in HRQoL research in its application as a tool for optimizing patients care and discusses the significance of the concept in treatment guidelines. Quality of life in clinical practice is discussed in terms of problems of the transfer of HRQoL research into clinical practice and the doctor-patients interaction and communication.