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In 1990, the World Health Organization emphasized that the ultimate goal of palliative care is achievement of the best QOL for patients and their families. Clinch and Schipper have suggested that QOL is the most appropriate outcome measure in terminal care because it is focused on what happens to the patient, measuring the effect of physiological change rather than only the fact of physiological change . Although there is no recognized gold standard for measurement of QOL, over the past decades, two classes of complementary health status measures have emerged to fill this information gap - objective measures of functional health status and subjective measures of health and well - being. Various QOL measurement tools have been designed but most may not be ideal for use in palliative care patients, whose QOL assessment should focus on areas for which palliative care is most effective, such as psychosocial and spiritual problems.
The Missoula-VITAS Quality of Life Index
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