Quality of life in hospitalized patients receiving palliative care: Do current tools cover all their needs?

Résumé

INTRODUCTION: Quality of life (QoL) is a central outcome in palliative care (PC), particularly in hospital settings, where patients often present with advanced illness, complex symptoms, and multidimensional needs. Accurate QoL assessment is essential to support patient-centered and family-centered decision-making; however, the diversity of available instruments and limited validation beyond oncology populations pose challenges for their clinical and research use.OBJECTIVES: We aimed to identify tools measuring QoL in hospitalized PC patients, highlighting their domains and psychometric properties.METHODS: A scoping review was conducted following Joanna Briggs Institute guidelines and the PRISMA Extension for Scoping Reviews (PRISMA-ScR). We searched MEDLINE (PubMed), CINAHL, EMBASE, The Cochrane Library, Scopus, Web of Science, Google Scholar, and LILACS from inception until April 11, 2025. Independent reviewers assessed eligibility, extracted data, and evaluated risk of bias.RESULTS: Of 6026 studies retrieved, after removing duplicates (n = 1680) and full-text screening (n = 17), 12 met inclusion criteria, including 5 validation, 5 observational studies and 2 clinical trials. Eight tools were identified, most originally developed for advanced-stage conditions and applied in high-income countries. Main domains included physical comfort (n = 7), psychological well-being (n = 7), and spiritual well-being (n = 7). Quality of death was assessed in one instrument. Two instruments were validated for Brazilian Portuguese, primarily for cancer patients. Frequently reported psychometric properties were face validity (n = 9), content validity (n = 6), and construct validity (n = 6).CONCLUSION: No gold-standard instrument exists for measuring QoL in PC. Selection should consider patient and family preferences, health status, prognosis, life expectancy, and intended use. Findings highlight the need for psychometrically robust instruments applicable across disease stages and conditions. Incorporation of death preparedness, quality of death, and patient- and family-centered outcomes remains limited but is important to guide individualized, safe, and equitable hospital-based PC.