Article Title

Is the life space assessment applicable to a palliative care population? Its relationship to measures of performance and quality of life

Abstract

Context

The spatial environments that palliative care patients frequent for business and leisure constrict as their disease progresses and their physical functioning deteriorates. Measuring a person's movement within his or her own environment is a clinically relevant and patient-centered outcome because it measures function in a way that reflects actual and not theoretical participation.

Objective

This exploratory study set out to test whether the Life-Space Assessment (LSA) would correlate with other commonly used palliative care outcome measures of function and quality of life.

Methods

The baseline LSA, Australian Karnofsky Performance Scale (AKPS), and the European Organization for the Research and Treatment of Cancer Quality of Life Questionnaire-Core 15-Palliative (EORTC QLQ-C15-PAL) scores from two large clinical trials were used to calculate correlation coefficients between the measures. Convergent validity analysis was undertaken by comparing LSA scores between participants with higher (≥70) and lower (≤60) AKPS scores.

Results

The LSA was correlated significantly and positively with the AKPS, with a moderate correlation coefficient of 0.54 (P < 0.001). There was a significant weak negative correlation between the LSA and the EORTC QLQ-C15-PAL, with a small coefficient of −0.22 (P = 0.027), but a strong correlation between the LSA and the EORTC QLQ-C15-PAL item related to independent activities of daily living (r = −0.654, P < 0.01). A significant difference in the LSA score between participants with higher (≥70) and lower (≤60) AKPS scores t(97) = −4.35, P < 0.001) was found.

Conclusion

The LSA appears applicable to palliative care populations given the convergent validity and capacity of this instrument to differentiate a person's ability to move through life-space zones by performance status. Further research is required to validate and apply the LSA within community palliative care populations.

Keywords

hospice, palliative care, activities of daily living, outcome measures, validation, performance status, mobility, quality of life

 

Link to Publisher Version (DOI)

http://doi.org/10.1016/j.jpainsymman.2013.06.017