Institute of Occupational, Social and Environmental Medicine, University Medical Center of the Johannes Gutenberg University of Mainz, Germany.
J Palliat Med. 2011 Oct;14(10):1097-103. doi: 10.1089/jpm.2011.0136.
Dying in the preferred place is considered a key requirement for a "good death." The aims of our study were to explore preferred places of death of deceased people and their bereaved relatives in Rhineland-Palatinate (Germany). We further wanted to assess the congruence between preferred and actual place of death.
The cross-sectional study was based on a random sample of 5000 inhabitants of Rhineland-Palatinate (Germany) who died between May 25 and August 24, 2008. Relatives of these deceased persons were interviewed by a written survey.
After removing duplicates, 4967 questionnaires were sent out, 3832 delivered, and 1378 completed, yielding a response rate of 36.0%. Regarding the deceased, 93.8% wanted to die at home, 0.7% in a hospital, 2.8% in palliative care, 2.4% in a nursing home, and 0.3% elsewhere. The figures for the relatives were 80.7%, 4.3%, 7.5%, 7.1%, and 0.5%, respectively. Of the deceased 58.9% and of the relatives 59.1% had their wish fulfilled. Logistic regression analysis revealed that living in a rural municipality (adjusted odds ratio [aOR]: 1.88; 95% confidence interval [CI]: 1.02-3.43), rural town (aOR: 2.30; 95% CI: 1.17-4.49) or small town (aOR: 1.95; 95% CI: 1.04-3.68), having a nonworking relative (aOR: 1.79; 95% CI: 1.16-2.76), and living together with a relative (aOR: 2.28; 95% CI:1.57-3.32) increases the probability to die in the preferred place.
Because the availability of a relative was the most important factor to die in the preferred place, relatives of dying people should be supported in providing informal care. The introduction of palliative home care teams should allow more people to die in their preferred place by easing the burden of informal carers.
在首选地点去世被认为是“善终”的关键要求。我们的研究目的是探讨莱茵兰-普法尔茨州（德国）去世者及其亲属的首选死亡地点。我们还想评估首选和实际死亡地点之间的一致性。
这项横断面研究基于对 2008 年 5 月 25 日至 8 月 24 日期间在莱茵兰-普法尔茨州去世的 5000 名居民的随机样本。通过书面调查对这些死者的亲属进行了采访。
剔除重复项后，共发出 4967 份问卷，送达 3832 份，完成 1378 份，应答率为 36.0%。对于死者，93.8%希望在家中去世，0.7%希望在医院，2.8%希望在姑息治疗病房，2.4%希望在养老院，0.3%希望在其他地方。对于亲属，相应的数字分别为 80.7%、4.3%、7.5%、7.1%和 0.5%。死者中 58.9%和亲属中 59.1%的人实现了自己的愿望。逻辑回归分析显示，居住在农村市（调整后的优势比[aOR]：1.88；95%置信区间[CI]：1.02-3.43）、农村镇（aOR：2.30；95%CI：1.17-4.49）或小镇（aOR：1.95；95%CI：1.04-3.68）、有非工作亲属（aOR：1.79；95%CI：1.16-2.76）和与亲属一起居住（aOR：2.28；95%CI：1.57-3.32）增加了在首选地点死亡的可能性。
由于亲属的可用性是在首选地点去世的最重要因素，因此应支持临终者的亲属提供非正式护理。姑息治疗家庭护理团队的引入应通过减轻非正式护理者的负担，使更多的人能够在他们首选的地点去世。
