Llobet Vila L, Manuel Carmona Segado J, Martínez Díaz I, Martí Martínez C, Soldado Ordoñez C, María Manresa Domínguez J
Medicina familiar y comunitaria, EAP Castellar del Vallès-Sant Llorenç, Institut Català de la Salut (ICS), Castellar del Vallès, Barcelona, España.
Medicina familiar y comunitaria, EAP Castellar del Vallès-Sant Llorenç, Institut Català de la Salut (ICS), Castellar del Vallès, Barcelona, España.
Semergen. 2020 Apr;46(3):186-193. doi: 10.1016/j.semerg.2019.10.009. Epub 2020 Jan 1.
Death is part of life. The awareness that death is inevitable could be the cause of mental disorders.
To determine the level of death anxiety in old people as regards age, gender, social aspects, physical and leisure activities, self-esteem, religion or advanced disease, as well as their preferences on the place where they want to die.
Cross-sectional observational study. Face-to-face interviews and Death Anxiety Scale (DAS) of Templer on 300 patients over 75years-old without a diagnosis of dementia, selected randomly in four health centres.
A total of 288 surveys were completed. The mean age was 84.8 (15.2) years, and 147 (51.0%) were older than 85years. The score of medium-high anxiety observed in the DAS was higher in women (50%-39.6%; P=.030), in those who did not perform physical activity (68%-26.4%; P<.001), in those who did not take part in leisure activities (63.5%-41.7%; P=.007), in patients with depressed mood (60.4%-41.6%; P<.008), and in patients without advanced disease (48.3%-3 5.8%; P=.036). The fear of having a painful death was present in 255 (88.5%). Physical activity reduced the risk of medium-high anxiety by 5.3 times (OR=.188, P<.001), and screening positive for depression increased it by 2.9 times (OR=2.943, P=.014). As regards the place where they would prefer to die, 177 (61.5%) answered «at home», and 28 (9.7%) «in the hospital.» CONCLUSIONS: Older people do fear a painful death, but they are not really afraid of dying. Male gender and performing physical or leisure activities is related to low levels of death anxiety. Advanced disease leads to greater acceptance of the end of life. The desire to die at home, and to «dehospitalise» the death prevails.
死亡是生命的一部分。意识到死亡不可避免可能是精神障碍的起因。
确定老年人在年龄、性别、社会层面、身体和休闲活动、自尊、宗教信仰或晚期疾病方面的死亡焦虑水平，以及他们对希望离世地点的偏好。
横断面观察性研究。在四个健康中心随机选取300名75岁以上未诊断为痴呆的患者进行面对面访谈，并使用坦普勒死亡焦虑量表（DAS）。
共完成288份调查问卷。平均年龄为84.8（15.2）岁，147名（51.0%）年龄超过85岁。在DAS中观察到的中高焦虑得分在女性中更高（50% - 39.6%；P = 0.030），在不进行体育活动的人群中更高（68% - 26.4%；P < 0.001），在不参加休闲活动的人群中更高（63.5% - 41.7%；P = 0.007），在情绪低落的患者中更高（60.4% - 41.6%；P < 0.008），在无晚期疾病的患者中更高（48.3% - 35.8%；P = 0.036）。255名（88.5%）患者存在对痛苦死亡的恐惧。体育活动使中高焦虑风险降低5.3倍（OR = 0.188，P < 0.001），抑郁筛查呈阳性使风险增加2.9倍（OR = 2.943，P = 0.014）。关于他们希望离世的地点，177名（61.5%）回答“在家中”，28名（9.7%）回答“在医院”。结论：老年人确实害怕痛苦的死亡，但并非真的害怕死亡本身。男性以及进行体育或休闲活动与低水平的死亡焦虑相关。晚期疾病导致对生命终结的更大接受度。希望在家中离世以及使死亡“非医院化”的意愿占主导。
