Daveson Barbara A, Alonso Juan P, Calanzani Natalia, Ramsenthaler Christina, Gysels Marjolein, Antunes Barbara, Moens Katrien, Groeneveld Esther I, Albers Gwenda, Finetti Silvia, Pettenati Francesca, Bausewein Claudia, Higginson Irene J, Harding Richard, Deliens Luc, Toscani Franco, Ferreira Pedro L, Ceulemans Lucas, Gomes Barbara
1 King's College London, Cicely Saunders Institute, Department of Palliative Care, Policy and Rehabilitation, UK.
2 CONICET and University of Buenos Aires, Buenos Aires, Argentina.
Eur J Public Health. 2014 Jun;24(3):521-7. doi: 10.1093/eurpub/ckt029. Epub 2013 Mar 13.
Despite ageing populations and increasing cancer deaths, many European countries lack national policies regarding palliative and end-of-life care. The aim of our research was to determine public views regarding end-of-life care in the face of serious illness.
Implementation of a pan-European population-based survey with adults in England, Belgium (Flanders), Germany, Italy, The Netherlands, Portugal and Spain. Three stages of analysis were completed on open-ended question data: (i) inductive analysis to determine a category-code framework; (ii) country-level manifest deductive content analysis; and (iii) thematic analysis to identify cross-country prominent themes.
Of the 9344 respondents, 1543 (17%) answered the open-ended question. Two prominent themes were revealed: (i) a need for improved quality of end-of-life and palliative care, and access to this care for patients and families and (ii) the recognition of the importance of death and dying, the cessation of treatments to extend life unnecessarily and the need for holistic care to include comfort and support.
Within Europe, the public recognizes the importance of death and dying; they are concerned about the prioritization of quantity of life over quality of life; and they call for improved quality of end-of-life and palliative care for patients, especially for elderly patients, and families. To fulfil the urgent need for a policy response and to advance research and care, we suggest four solutions for European palliative and end-of-life care: institute government-led national strategies; protect regional research funding; consider within- and between-country variance; establish standards for training, education and service delivery.
尽管人口老龄化且癌症死亡人数不断增加，但许多欧洲国家缺乏关于姑息治疗和临终关怀的国家政策。我们研究的目的是确定公众对重症患者临终关怀的看法。
在英国、比利时（弗拉芒地区）、德国、意大利、荷兰、葡萄牙和西班牙对成年人开展一项泛欧洲的基于人群的调查。对开放式问题数据完成了三个阶段的分析：（i）归纳分析以确定类别编码框架；（ii）国家层面的显性演绎内容分析；（iii）主题分析以识别跨国突出主题。
在9344名受访者中，1543人（17%）回答了开放式问题。揭示了两个突出主题：（i）需要提高临终和姑息治疗的质量，以及患者及其家庭获得这种治疗的机会；（ii）认识到死亡和临终的重要性，停止不必要的延长生命的治疗，以及需要全面护理以包括舒适和支持。
在欧洲，公众认识到死亡和临终的重要性；他们关注生命数量优先于生命质量的问题；他们呼吁提高患者尤其是老年患者及其家庭的临终和姑息治疗质量。为满足对政策回应的迫切需求并推进研究和护理，我们为欧洲姑息治疗和临终关怀提出四个解决方案：制定政府主导的国家战略；保护区域研究资金；考虑国家内部和国家之间的差异；建立培训、教育和服务提供的标准。
