Jorge Rafaela, Calanzani Natália, Freitas Adelaide, Nunes Rui, Sousa Liliana
Doctoral Program in Gerontology and Geriatrics, University of Aveiro. Campus Universitário de Santiago. 3810-193 Portugal.
Centre for Population Health Sciences, University of Edinburgh. Edinburgh United Kingdom.
Cien Saude Colet. 2019 Aug 5;24(8):3001-3012. doi: 10.1590/1413-81232018248.24102017.
We examined people's preferences for place of death and identified factors associated with a home death preference. We asked a representative sample (N = 400) of older people (≥ 60 years) residents in the city of Belo Horizonte, about their preferences for place of death in a situation of serious illness with less than a year to live. Data were analyzed using binomial regression to identify associated factors. 52.2% indicate home as the preferred place of death. Five variables were associated with preference for death at home: those living with 1 child (odds ratio (OR)0.41; 95% confidence interval (CI):0.18-0.92; ref: without children); being in education for up to 4 years (OR0.42; 95% CI:0.20-0.89; ref: higher education); finding it difficult to live with the present income (OR3.18; 95% CI:1.53-6.62; ref: living comfortably); self-assessed fair overall health (OR2.07; 95% CI:1.06-4.03; ref: very good health) and selecting "choosing who makes decisions about your care" as the care priority that would matter to them the most (OR2.43; 95%CI:1.34-4.40; ref: dying in the place you want). Most respondents chose home as preferred place of death. However, most residents of Belo Horizonte die in hospitals, suggesting that preferences are not being considered.
我们研究了人们对死亡地点的偏好，并确定了与在家中死亡偏好相关的因素。我们询问了贝洛奥里藏特市400名年龄在60岁及以上的老年人的代表性样本，了解他们在患有严重疾病且预期寿命不到一年的情况下对死亡地点的偏好。使用二项式回归分析数据以确定相关因素。52.2%的人表示希望在家中死亡。有五个变量与在家中死亡的偏好相关：与一个孩子同住（优势比（OR）0.41；95%置信区间（CI）：0.18 - 0.92；参照：无子女）；接受教育年限达4年（OR0.42；95%CI：0.20 - 0.89；参照：高等教育）；认为以目前的收入难以维持生活（OR3.18；95%CI：1.53 - 6.62；参照：生活舒适）；自我评估总体健康状况一般（OR2.07；95%CI：1.06 - 4.03；参照：非常健康）以及选择“选择谁来决定你的护理”作为对他们最重要的护理优先事项（OR2.43；95%CI：1.34 - 4.40；参照：在你希望的地方去世）。大多数受访者选择在家中作为首选的死亡地点。然而，贝洛奥里藏特的大多数居民在医院死亡，这表明他们的偏好未被考虑。
