Measuring quality of life in hospice care.

Hospice care has developed along different paths in Europe, North America, and other cultures. Even within Britain, there is a diversity of hospice models--in-patient units, hospital support teams, day care and home care, with a broad range of clinical services offered. In assessing the clinical results of a hospice service, it is important to bear these differences in mind. Now that more formal, experimental controlled research is being conducted in hospices, there is an opportunity to evaluate quality of life in the same way that has become accepted in clinical cancer trials. The range of evaluations is reviewed, from purely physical assessment to psychological, social, and spiritual problems and the monitoring of bereavement. It is clear that new measurement instruments are needed, particularly for the social and spiritual problems of hospice patients and their families.