Table 1 The Qol assessment principles in palliative care

The problem (the Qol impairment)

1. The problem should be a serious condition for the patient either in terms of prevalence (e.g., pain, depression) and/or distress for the patient (e.g., itch, hiccup) or the result of late detection and management of the problem (e.g., a new or unusual distressing symptom occurred over the disease trajectory).

2. The problem should be highly unlikely to be reported by the patient or recognized by the professional if not actively assessed.

3. The trajectory of the problem should be sufficiently understood to assure a timely assessment to anticipate and appropriately address the problem.

The assessment tool

4. A validated, reliable, and sensitive-to-change tool for detecting and measuring the problem should be available.

5. The tool should be practical and easy to use, and questions must not be distressing for the patients.

The treatment-intervention

6. There should be an appropriate treatment/intervention for patients with the recognized problem.

The clinical intervention focused on Qol assessment

7. There should be an agreed policy on which a problem (or a problem with a certain degree of impairment) has to be addressed with appropriate treatment or intervention.

8. It should be possible for the tool to be appropriately administered by professionals trained in the procedure.

9. The treatment-intervention for patients with QoL impairments should be available, with appropriately trained professionals.

10. The cost of problem-finding (including all the steps from the administration of the tool until the treatment-intervention has been delivered in full) should be economically justified.

11. QoL assessment should be a continuing process rather than a one-off assessment.