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南澳大利亚普通人群中死亡首选地点的预测因素。

Factors predictive of preferred place of death in the general population of South Australia.

作者信息

Foreman Linda M, Hunt Roger W, Luke Colin G, Roder David M

机构信息

The Cancer Council South Australia, Adelaide.

出版信息

Palliat Med. 2006 Jun;20(4):447-53. doi: 10.1191/0269216306pm1149oa.

Abstract

In a population survey, 2652 respondents aged 15+ years reported their preferred place of death, if dying of 'a terminal illness such as cancer or emphysema', to be home (70%), a hospital (19%), hospice (10%), or nursing home (<1%). The majority of respondents in all socio-demographic categories reported a preference for dying at home, with the greatest majorities occurring in younger age groups. After weighting to the age-sex distribution of all South Australian cancer deaths, 58% in our survey declared a preference to die at home, which is much higher than the 14% of cancer deaths that actually occurred at home in South Australia in 2000-2002. Multivariable analyses indicate that predictors of preferred home death include younger age, male, born in the UK/Ireland or Italy/Greece, better physical health, poorer mental health, and fewer concerns about dying at home. Predictors of preference for death in a hospice rather than hospital include older age, female, single, metropolitan residence, having higher educational and income levels, paid employment, awareness of advanced directives, and interpreting 'dying with dignity' as death without pain or suffering. Investigating the differences between preferred and actual places of death may assist service providers to meet end-of-life wishes.

摘要

在一项人口调查中,2652名15岁及以上的受访者表示,如果死于“癌症或肺气肿等晚期疾病”,他们希望离世的地点是家中(70%)、医院(19%)、临终关怀机构(10%)或养老院(不到1%)。所有社会人口学类别的大多数受访者都表示倾向于在家中离世,其中年龄较小的群体占比最高。根据南澳大利亚州所有癌症死亡病例的年龄 - 性别分布进行加权后,我们调查中有58%的人表示希望在家中离世,这远高于2000 - 2002年南澳大利亚州实际在家中发生的癌症死亡病例的14%。多变量分析表明,希望在家中离世的预测因素包括年龄较小、男性、出生在英国/爱尔兰或意大利/希腊、身体健康状况较好、心理健康状况较差以及对在家中离世的担忧较少。相比于医院,更倾向于在临终关怀机构离世的预测因素包括年龄较大、女性、单身、居住在大城市、教育和收入水平较高、有带薪工作、了解生前预嘱以及将“尊严地死去”理解为无痛苦或无折磨地死亡。调查希望离世地点与实际离世地点之间的差异可能有助于服务提供者满足临终愿望。

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