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doi:10.1378/chest.07-1392
(Chest. 2007; 132:404S-422)
© 2007 American College of Chest Physicians
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Palliative Care Consultation, Quality-of-Life Measurements, and Bereavement for End-of-Life Care in Patients With Lung Cancer*

ACCP Evidence-Based Clinical Practice Guidelines (2nd Edition)

John P. Griffin, MD, FCCP; Kathryn A. Koch, MD, FCCP; Judith E. Nelson, MD, JD, FCCP and Mary E. Cooley, RN, PhD

* From the Division of Pulmonary, Critical Care, and Sleep Medicine (Dr. Griffin), Department of Medicine, University of Tennessee Health Science Center, Memphis, TN; the Division of Pulmonary and Critical Care Medicine (Dr. Koch), Department of Internal Medicine, University of Florida Health Science Center, Jacksonville, FL; the Division of Pulmonary and Critical Care Medicine (Dr. Nelson), Department of Medicine, Mount Sinai Medical Center, New York, NY; and the Phyllis F. Cantor Center for Research in Nursing and Patient Care (Dr. Cooley), Dana-Farber Cancer Institute, Boston, MA.

Correspondence to: John P. Griffin, MD, FCCP, University of Tennessee Health Science Center, 956 Court Ave, Room H314, Memphis, TN 38163; e-mail: jpgriffin{at}utmem.edu

Objective: To develop clinical practice guidelines for application of palliative care consultation, quality-of-life measurements, and appropriate bereavement activities for patients with lung cancer.

Methods: To review the pertinent medical literature on palliative care consultation, quality-of-life measurements, and bereavement for patients with lung cancer, developing multidisciplinary discussions with authorities in these areas, and evolving written guidelines for end-of-life care of these patients.

Results: Palliative care consultation has developed into a new specialty with credentialing of experts in this field based on extensive experience with patients in end-of-life circumstances including those with lung cancer. Bereavement studies of the physical and emotional morbidity of family members and caregivers before, during, and after the death of a cancer patient have supported truthful communication, consideration of psychological problems, effective palliative care, understanding of the patient’s spiritual and cultural background, and sufficient forewarning of impending death.

Conclusion: Multidisciplinary investigations and experiences, with emphasis on consultation and delivery of palliative care, timely use of quality-of-life measurements for morbidities of treatment modalities and prognosis, and an understanding of the multifaceted complexities of the bereavement process, have clarified additional responsibilities of the attending physician.

Key Words: bereavement • cultural competence • end-of-life care • lung cancer • palliative care consultation • quality-of-life measurements






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