Cartwright A
Institute for Social Studies in Medical Care, London.
J Public Health Med. 1991 May;13(2):81-7.
Studies based on random samples of adult deaths in 1969 and 1987 show that, although more people in the recent study were living alone in the year before they die (32 per cent compared with 15 per cent in the earlier study), there had also been an increase in the proportions living in institutions and being admitted to hospital in the 12 months before their death. More of those dying in 1987 than in 1969 had had a home help, whereas the proportion receiving care from district nurses was similar for the two studies and the amount of home visiting by general practitioners had fallen. A higher proportion of those dying of cancer in 1987 than in 1969 were thought to have known that they were dying (44 per cent against 16 per cent) and that they had cancer (73 per cent compared with 29 per cent). However, the proportion of relatives and others who thought the dying person's awareness, or lack of awareness, of the prognosis was 'best as it was' was lower for people dying of cancer in the more recent study (57 per cent against 69 per cent). The symptoms reported for those dying in 1969 and 1987 were generally similar but more of those who died in 1987 had suffered from mental confusion, depression and incontinence for a year or more. This reflects the increased age at which people were dying in the later study: longer life was sometimes associated with the prolongation of unpleasant symptoms.
基于1969年和1987年成年人死亡随机样本的研究表明，尽管在最近的研究中，更多的人在去世前一年独自生活（32%，而早期研究为15%），但在去世前12个月入住机构和住院的比例也有所增加。1987年去世的人中接受上门护理服务的比1969年更多，而两项研究中接受社区护士护理的比例相似，全科医生的家访次数有所减少。1987年死于癌症的人中，认为自己即将死亡（44%，而1969年为16%）以及知晓自己患有癌症（73%，而1969年为29%）的比例更高。然而，在最近的研究中，认为临终者对预后的知晓情况“最好保持原样”的亲属及其他人的比例，在死于癌症的人群中更低（57%，而之前为69%）。1969年和1987年去世者报告的症状总体相似，但1987年去世的人中，更多的人在去世前一年或更长时间出现精神错乱、抑郁和大小便失禁等症状。这反映出在后期研究中人们的死亡年龄有所增加：寿命延长有时伴随着不适症状的延长。
