Department of Primary Care and Population Health, University College London, Royal Free Campus, London NW3 2PF, UK.
Postgrad Med J. 2010 Apr;86(1014):197-202. doi: 10.1136/pgmj.2009.084020.
To examine fears about dying in an ethnically diverse population sample, and a more homogeneous population sample, aged 65 and over.
Personal interviews with people aged 65+ living at home responding to two Office for National Statistics Omnibus Surveys in Britain, and two Ethnibus Surveys of ethnically diverse populations in Britain.
Ethnically diverse respondents were more likely than British population respondents to express fears about dying on all measures used. Respondents in both samples with better, compared with worse, quality of life had significantly reduced odds of having extreme fears of dying (ethnically diverse sample, OR 0.924 (95% CI 0.898 to 0.951); British population sample, OR 0.981 (95% CI 0.966 to 0.996); both p<0.001). In the latter sample only, older age was protective (OR 0.957; 95% CI 0.930 to 0.985; p<0.001), whereas in the Ethnibus sample, having a longstanding illness (OR 2.024; 95% CI 1.158 to 3.535; p<0.05) and having more relatives to help them (OR 1.134; 95% CI 1.010 to 1.274; p<0.05) increased fears about dying.
Enabling older people to express fears about dying is likely to be important when planning supportive end-of-life care. Practitioners should not assume that fears about dying are the same in different social groups, or that extensive family support is protective against such anxiety. Older people from ethnic minorities had more anxieties about dying than others, and were more likely to express fears the more extensive their family support. These findings have implications for commissioners and practitioners of primary and secondary care.
在一个种族多样化的人群样本和一个更同质的 65 岁及以上人群样本中,研究对死亡的恐惧。
对居住在英国的 65 岁以上的人群进行个人访谈,他们是英国国家统计局两个综合调查和两个英国种族多样化人群 Ethnibus 调查的参与者。
与英国人口样本相比,种族多样化的受访者在所有使用的衡量指标上更有可能表达对死亡的恐惧。在两个样本中,生活质量较好的受访者与生活质量较差的受访者相比,对死亡的极度恐惧的可能性显著降低(种族多样化样本,OR 0.924(95%CI 0.898 至 0.951);英国人口样本,OR 0.981(95%CI 0.966 至 0.996);均 p<0.001)。在后一个样本中,只有年龄较大具有保护作用(OR 0.957;95%CI 0.930 至 0.985;p<0.001),而在 Ethnibus 样本中,患有长期疾病(OR 2.024;95%CI 1.158 至 3.535;p<0.05)和有更多的亲戚帮助他们(OR 1.134;95%CI 1.010 至 1.274;p<0.05)增加了对死亡的恐惧。
在规划支持性临终关怀时,让老年人表达对死亡的恐惧可能很重要。从业者不应假设不同社会群体对死亡的恐惧是相同的,也不应假设广泛的家庭支持可以预防这种焦虑。少数民族老年人比其他人对死亡的焦虑更多,而且他们的家庭支持越广泛,就越有可能表达恐惧。这些发现对初级和二级保健的决策者和从业者具有启示意义。