Abstract

Background: Little is known about what factors affect Quality of Life (QoL) in persons with cancer who are in the palliative phase of their disease. This Umbrella Review (UR) aims to systematically examine psychological, social and clinical factors affecting QoL in the Palliative Care of advanced cancer. Methods: Four scientific databases (PubMed, Embase, Scopus, and PsycInfo) were searched to identify systematic reviews between 2021 and 2023, involving adult cancer patients in PC, and analyzing the relationship between QoL and psychosocial and/or clinical factors. The data extraction and synthesis process followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, and risks of bias were assessed using the Assessment of Multiple Systematic Reviews 2 (AMSTAR2) rating scale. Results: Three systematic reviews were included, with different study designs and a total of 182,647 subjects across different cancer types. Depression and spirituality/religiosity emerged as recurrent themes impacting QoL. Additionally, clinical variables such as pain intensity, fatigue, and medical treatment strategies revealed associations with QoL. Family support/function was identified as the only social factor positively influencing QoL. Conclusion: Findings highlight the importance of addressing spirituality, anxiety, depression, and family support in Palliative Care settings to improve the QoL of cancer patients and caregivers. This UR is a useful resource for researchers, clinicians, and policymakers because it underlines the association between QoL and a variety of psychosocial and clinical factors in EoL cancer patients and gives an overview of the concept of QoL in this cancer population.