Hales Sarah, Zimmermann Camilla, Rodin Gary
Department of Psychosocial Oncology & Palliative Care, Princess Margaret Hospital, University Health Network, Toronto, Ontario, Canada.
Arch Intern Med. 2008 May 12;168(9):912-8. doi: 10.1001/archinte.168.9.912.
During the past decade, research has examined definitions and conceptualizations of quality of dying and death in different populations. At the same time, there has been a call to clarify the distinctions between quality of dying and death and other end-of-life constructs. The purposes of this article are to (1) review research that examined definitions and conceptualizations of the quality of dying and death, (2) clarify the quality of dying and death construct and its distinction from quality of life and quality of care at the end of life, and (3) outline challenges that remain for health care professionals, researchers, and policy makers. Review of the literature revealed that the quality of dying and death construct is multidimensional, with 7 broad domains: physical experience, psychological experience, social experience, spiritual or existential experience, the nature of health care, life closure and death preparation, and the circumstances of death. The quality of dying and death is subjectively determined with numerous factors that influence its judgment, including culture, type and stage of disease, and social and professional role in the dying experience. Quality of dying and death is broader in scope than either quality of life at the end of life or quality of care at the end of life, although there is overlap among these constructs.
在过去十年中，研究探讨了不同人群中临终及死亡质量的定义和概念。与此同时，人们呼吁明确临终及死亡质量与其他生命末期概念之间的区别。本文的目的是：（1）回顾探讨临终及死亡质量定义和概念的研究；（2）阐明临终及死亡质量这一概念及其与生命末期生活质量和护理质量的区别；（3）概述医疗保健专业人员、研究人员和政策制定者仍然面临的挑战。文献回顾显示，临终及死亡质量这一概念具有多维度性，包含7个广泛领域：身体体验、心理体验、社会体验、精神或存在体验、医疗保健的性质、生命终结与死亡准备，以及死亡情形。临终及死亡质量是由多种影响其判断的因素主观决定的，这些因素包括文化、疾病类型和阶段，以及在临终体验中的社会和职业角色。临终及死亡质量的范围比生命末期的生活质量或护理质量更广，尽管这些概念之间存在重叠。
