Chindaprasirt Jarin, Wongtirawit Nattapat, Limpawattana Panita, Srinonprasert Varalak, Manjavong Manchumad, Chotmongkol Verajit, Pairojkul Srivieng, Sawanyawisuth Kittisak
Division of Oncology Medicine, Department of Internal Medicine, Faculty of Medicine, Khon Kaen University, Thailand.
Residency Training in Department of Internal Medicine, Faculty of Medicine, Khon Kaen University, Thailand.
Heliyon. 2019 Jul 12;5(7):e02067. doi: 10.1016/j.heliyon.2019.e02067. eCollection 2019 Jul.
Understanding the perceptions regarding what constitutes a "good death" among cancer patients and their families could help healthcare teams to ensure proper palliative and supportive care.
To demonstrate and compare the wishes cancer patients and the perceptions of their relatives regarding end-of-life care, and to identify factors associated with patients' preferences regarding place of death.
A sample of cancer patients and their relatives who attended the Srinagarind Hospital (Thailand) oncology clinic or day chemotherapy from September 2017 to August 2018 were enrolled. Questionnaires were given to the participants, in which the patients were asked to respond based on their own end-of-life preferences, and relatives were asked to imagine how the patients would respond to the questions.
One hundred eighty pairs of patients and relatives were recruited. Respondents in both groups placed importance on place of death, relationship with family, physical and psychological comfort, and relationship with the medical staff. Both groups generally agreed with the statements on the questionnaire (10/13 statements). Relatives underestimated the preferences of the patients in 3 areas: "not being a burden to others," "preparation for death," and "physical and psychological comfort." Being married (adjusted odds ratio (AOD) 6.4, 95%confidence interval (CI) 1.1,36.5), having had more than 6 years of education (AOD 6.5, 95%CI 1.8,23.7), having lung cancer compared to colon cancer (AOD 12, 95%CI 1.2,118.7), duration after cancer diagnosis (AOD 0.9, 95%CI 0.93,0.99), previous hospital admission (AOD 5.7, 95%CI 1.5,21.2), and life satisfaction (AOD 17.6, 95%CI 2.9,104.9) were factors associated with preference for home death.
Thai cancer patients and their relatives indicated similar preferences with regard to what constitutes a good death and patients' wishes for their end-of-life period. However, the patients' relatives underestimated the importance patients placed on statements in three domains. Factors that influenced a preference for a home death were identified.
了解癌症患者及其家属对“善终”的看法有助于医疗团队提供适当的姑息治疗和支持性护理。
展示并比较癌症患者及其亲属对临终关怀的意愿和看法，并确定与患者死亡地点偏好相关的因素。
选取2017年9月至2018年8月在泰国诗里拉吉医院肿瘤门诊或日间化疗就诊的癌症患者及其亲属作为样本。向参与者发放问卷，要求患者根据自己的临终偏好作答，亲属则需设想患者会如何回答这些问题。
招募了180对患者和亲属。两组受访者均重视死亡地点、与家人的关系、身体和心理舒适度以及与医护人员的关系。两组总体上都同意问卷中的陈述（13条陈述中的10条）。亲属在三个方面低估了患者的偏好：“不给他人添麻烦”、“为死亡做准备”以及“身体和心理舒适度”。已婚（调整优势比[AOD]6.4，95%置信区间[CI]1.1，36.5）、接受过6年以上教育（AOD 6.5，95%CI 1.8，23.7）、与结肠癌患者相比患有肺癌（AOD 12，95%CI 1.2，118.7）、癌症诊断后的时长（AOD 0.9，95%CI 0.93，0.99）、既往住院史（AOD 5.7，95%CI 1.5，21.2）以及生活满意度（AOD 17.6，95%CI 2.9，104.9）是与选择在家中死亡相关的因素。
泰国癌症患者及其亲属在善终的构成要素以及患者对临终阶段的期望方面表现出相似的偏好。然而，患者亲属低估了患者在三个领域对陈述的重视程度。确定了影响在家中死亡偏好的因素。
