Chen Qian, Flaherty Joseph Henry, Guo Ju Hong, Zhou Yan, Zhang Xue Mei, Hu Xiu Ying
1 Department of Geriatrics, West China Hospital and National Clinical Research Center for Geriatrics, Sichuan University, Chengdu, Sichuan Province, China .
2 Department of Internal Medicine and Division of Geriatrics, St. Louis University School of Medicine, St. Louis, Missouri.
J Palliat Med. 2017 Dec;20(12):1389-1394. doi: 10.1089/jpm.2017.0014. Epub 2017 Sep 7.
Due to the aging population of China, the need for palliative care will increase. However, one of the barriers to utilization of palliative care is the traditional belief that talking about death and dying is taboo.
The aim of this study was to examine to what extent older Chinese patients were willing to answer questions about death and dying by asking them about "fear of death" and their desire to "use advanced life support when dying."
Survey questionnaire.
SETTING/SUBJECTS: Convenience sample (N = 993 hospitalized patients).
Only 215 (21.7%; 95% confidence interval [CI] 16.2%-27.1%) and 99 (9.9%; 95% CI 4.1%-15.8%) patients did not answer the questions related to "fear of death" and "use of advanced life support when dying," respectively, while 439 (44.2%; 95% CI 38.7%-49.7%) answered "yes" and 339 (34.1%; 95% CI 28.7%-39.6%) answered "no" for "fear of death" and 382 (38.5%; 95% CI 32.6%-44.3%) answered "yes" and 512 (51.6%; 95% CI 45.7%-57.4%) answered "no" for "use of advanced life support when dying." In multinomial logistic regression analysis, fear of death was associated with younger age, lowest level of function, and desire to use advanced life support.
The majority of older patients were willing to answer the two questions about death and dying. About one-third of patients were not afraid of death, and older patients were less likely to be afraid of death. More than 50% of patients answered that they would not choose advanced life support when dying. More research in this area is needed to help advance palliative care in China.
由于中国人口老龄化，对姑息治疗的需求将会增加。然而，姑息治疗利用的障碍之一是传统观念认为谈论死亡是禁忌。
本研究的目的是通过询问老年中国患者“对死亡的恐惧”以及他们在“临终时使用高级生命支持”的意愿，来考察他们在多大程度上愿意回答有关死亡的问题。
调查问卷。
设置/对象：便利样本（N = 993名住院患者）。
分别只有215名（21.7%；95%置信区间[CI] 16.2% - 27.1%）和99名（9.9%；95% CI 4.1% - 15.8%）患者未回答与“对死亡的恐惧”和“临终时使用高级生命支持”相关的问题，而对于“对死亡的恐惧”，439名（44.2%；95% CI 38.7% - 49.7%）回答“是”，339名（34.1%；95% CI 28.7% - 39.6%）回答“否”；对于“临终时使用高级生命支持”，382名（38.5%；95% CI 32.6% - 44.3%）回答“是”，512名（51.6%；95% CI 45.7% - 57.4%）回答“否”。在多项逻辑回归分析中，对死亡的恐惧与年龄较小、功能水平最低以及使用高级生命支持的意愿相关。
大多数老年患者愿意回答这两个有关死亡的问题。约三分之一的患者不怕死，且老年患者更不太可能怕死。超过50%的患者回答他们临终时不会选择高级生命支持。需要在该领域进行更多研究以推动中国的姑息治疗发展。
