These results support the EORTC QLQ-C30 as a reliable and valid measure of the quality of life of cancer patients in multicultural clinical research settings. Work is ongoing to examine the performance of the questionnaire among more heterogenous patient samples and in phase II and phase III clinical trials.

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The aim of this study was to explore the reasons why patients and families are referred to specialist palliative care. Semi-structured interviews were undertaken with patients and professionals from primary care and specialist palliative care services in the north of England. A content analysis of the transcripts was undertaken, key issues were identified and common themes grouped. Twelve professionals working in specialist palliative care, three GPs, six community nurses and thirteen patients were interviewed (n = 34). Five key themes are reported: reasons why patients are referred to specialist palliative care; reasons why patients are not referred to specialist palliative care; timeliness of referrals; continuity of care; and use of referral criteria. It was found that the professionals in primary care would like more training and education about how to refer patients to specialist palliative care and how to deal with issues of death and dying. The patients were generally satisfied with the service but wanted to be able to be supported at home in their final days. Further training and education may improve the knowledge of professionals who refer patients to specialist palliative care. There are currently no standardized criteria in the UK to determine when a referral should be triggered. The development of a set of standardized referral criteria may be useful in aiding a referral decision.

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This paper reports on the methodological and ethical issues that were encountered when using focus groups to explore older people's knowledge, beliefs and risk perceptions about the use of innovative health technologies in end of life care. Older people drawn from community organisations in Sheffield, England, took part in discussions about the application of ‘life prolonging’ and ‘comfort care’ technologies during serious illness and impending death. The paper offers a reflective account of the management of recruitment and informed consent, and of the issues that arose when facilitating group discussions of potentially distressing material. It concludes with a brief account of the steps that were taken to enhance the ‘credibility’ of the data.

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