Powell Richard A, Namisango Eve, Gikaara Nancy, Moyo Sherperd, Mwangi-Powell Faith N, Gomes Barbara, Harding Richard
HealthCare Chaplaincy, New York, New York, USA; African Palliative Care Association, Kampala, Uganda.
African Palliative Care Association, Kampala, Uganda.
J Pain Symptom Manage. 2014 Mar;47(3):620-30. doi: 10.1016/j.jpainsymman.2013.04.004. Epub 2013 Jul 18.
Although quality end-of-life care provision is an international public health issue, the majority of evidence is not generated in low- and middle-income countries that bear a disproportionate burden of progressive illnesses.
To identify the priorities and preferences of the Namibian public for end-of-life care.
Using a cross-sectional study design, data were collected in the country's capital, Windhoek, from November to December 2010.
In total, 200 respondents were recruited. The mean age was 27 years (SD 7.5; range 18-69), with nearly all (n = 199; 99.5%) expressing a religious affiliation. Being in pain was reported as the most concerning of nine common end-of-life symptoms and problems (n = 52; 26.1%), and the most important care-related aspect was having as much information as wanted (n = 144; 72%). The majority (64%) would want their end-of-life care to focus on improving their quality of life rather than extending it, with 40% not wanting to know if they had limited time left to live. Hospital (n = 96; 48%) and home (n = 64; 32%) were the most preferred places of death. The most important end-of-life priority was keeping a positive attitude (n = 128; 64%). Having had a close relative or friend diagnosed with a serious illness was associated with a 2.3 increase in the odds of preference for a hospital death (odds ratio = 2.34, P = 0.009, 95% CI 1.23-4.47).
This study identified a number of areas that need to be pursued in future research to explore factors that may affect patient preferences and priorities in end-of-life care in Namibia.
尽管优质的临终关怀是一个国际公共卫生问题，但大多数证据并非来自那些承受着不成比例的渐进性疾病负担的低收入和中等收入国家。
确定纳米比亚公众对临终关怀的优先事项和偏好。
采用横断面研究设计，于2010年11月至12月在该国首都温得和克收集数据。
共招募了200名受访者。平均年龄为27岁（标准差7.5；范围18 - 69岁），几乎所有人（n = 199；99.5%）都表示有宗教信仰。在九种常见的临终症状和问题中，疼痛被报告为最令人担忧的问题（n = 52；26.1%），与护理相关的最重要方面是获得所需的尽可能多的信息（n = 144；72%）。大多数人（64%）希望他们的临终关怀重点是提高生活质量而非延长生命，40%的人不想知道自己是否所剩时间有限。医院（n = 96；48%）和家中（n = 64；32%）是最希望的死亡地点。临终最重要的优先事项是保持积极的态度（n = 128；64%）。有近亲或朋友被诊断患有严重疾病与选择在医院死亡的几率增加2.3倍相关（优势比 = 2.34，P = 0.009，95%置信区间1.23 - 4.47）。
本研究确定了一些未来研究需要探讨的领域，以探索可能影响纳米比亚临终关怀患者偏好和优先事项的因素。
