[International Classification of Functioning, Disability and Health (ICF) and quality of life in cancer patients in a terminal condition].

Quality of life (QoL) preservation for the patient with cancer in a terminal condition is a central goal in palliative care. Aim of the present study is to assess QoL and to verify the additive value of the ICF in a sample of cancer inpatients of a palliative care unit. Method. 32 terminal palliative care inpatients were evaluated by means of traditional assessment tools: Karnofsky Performance Status (KPS), Palliative Prognostic Index (PPI), Barthel Index (BI), SF-12, EuroQol VAS (today and last 30 days) and ICF checklist. Results. Among the 32 patients (age 70.4 +/- 10.2), 17 male (53.1%) and 15 female (49.6%), 8 were alive at the end of the study (24 deceased: survival days 41.0 +/- 46.4). As to the traditional assessment instruments, patients resulted severely impaired: KPS 30.0 +/- 10.4; PPI 5.7 +/- 2.7; BI 35.6 +/- 22.2; EuroQol-VAS today 46.5 +/- 19.7; EuroQol-VAS last 30 days 29.0 +/- 22.5; SF-12: PCS 29.2 +/- 8.1 e MCS 39.7 +/- 11.8. As to the ICF Activity and Participation categories 21 out of 42 (with equipment aids only) and 12 out of 42 (with equipment aids and with a person's help) resulted at least mildly impaired in > or =50% of patients. Delta values of the former scores (caregiver's impact) were calculated: in 10 categories the median value was > or =1 (caregiver as a positive disability modulator) and in 32 the median value was 0 (neutral role of the caregiver). Environmental Factors were mainly facilitators. Conclusions. Traditional QoL assessment highlights the severity of this condition. Whereas the ICF Checklist shows a more diversified situation, where some aspects of daily life are maintained, safeguarding personal dignity and family role. An integrated use of these instruments may grant an overall assessment, showing both difficulties and resources, confirming the importance of a unique interdisciplinary approach with patients at end of life.