QOL, as assessed by the patient with ALS, does not correlate with measures of strength and physical function, but appears to depend on psychological and existential factors, and thus may be measured well by the MQOL scale. Spiritual factors and support systems appear to play roles as well. SIP/ALS-19 is a good measure of physical function, but not of overall QOL.

QOL in patients with ALS appears to be independent of physical function, which agrees with a previous cross-sectional study. The ALS-specific health-related QOL score is primarily a measure of physical function. QOL instruments that assess spiritual, religious, and psychological factors produce different results than those obtained using measures of physical function alone.

Bugen's Coping with Death Scale, originally found to reflect gains in a death and dying seminar, was found in the present study to be internally consistent and stable on retest. It was negatively associated with the Templer and Collett-Lester scales, providing some convergent validation. It was not associated with Social Desirability but was associated with general anxiety; thus, discriminant validity was mixed. Individuals who had written wills, planned estates, planned their funerals, and signed organ donor cards scored higher on the Coping with Death Scale. Organ donors also reported less anxiety on the Templer and all four Collett-Lester scales. Since Coping with Death scores were more consistently different in those who prepare for death, this scale may help in efforts to predict those who will engage in such behaviors.

Three groups of hospice volunteers, trainees (N = 52), medium-term (2 to 42 months, N = 94), long-term (48 months or more, N = 96), and nonhospice and nonpatient care controls (N = 78) completed Bugen's Coping with Death Scale, the Templer/McMordie Death Anxiety Scale, and a new self-efficacy scale related to hospice and the ability to deal with death in general. The groups did not differ on the Death Anxiety Scale. However, on the Coping with Death Scale, experienced volunteers scored higher than trainees and controls; and on the self-efficacy scale all hospice volunteer groups believed themselves more able to deal with death than controls. In this study, the death competency scales appear more useful than the death anxiety measure in distinguishing hospice patient care volunteers from controls. The potential usefulness of these scales in future efforts at selection and evaluation are noted.