中国大陆临终关怀的接受情况及其影响因素：一项全国性的横断面研究。
What are the acceptances and associated influences of hospice care in Mainland China? A national cross-sectional study.
机构信息
Key Laboratory of Oral Biomedical Research of Zhejiang Province, Stomatology Hospital, School of Stomatology, Zhejiang University of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Cancer Center of Zhejiang University, Hangzhou, China.
Department of Surgical Oncology, Sir Run Run Shaw Hospital, Zhejiang University, Hangzhou, China.
出版信息
Front Public Health. 2022 Sep 23;10:985218. doi: 10.3389/fpubh.2022.985218. eCollection 2022.
BACKGROUND
China ranks 53 out of 81 countries in the Quality of Death Index for 2021. Although hospice care demand is increasing, the progress remains slow. It is of great significance to explore the acceptances and associated influencing factors of hospice care.
METHODS
A cross-sectional survey by quota sampling was conducted in China from July 10 to September 15, 2021. We collected demographic data and hospice care acceptance. A stepwise linear regression analysis was used.
RESULTS
This survey contained 11,031 valid questionnaire results to investigate the hospice care acceptance. It was found that individuals with undergraduate or above (β = 0.04), more properties [2 (β = 0.02), 3 (β = 0.01)], and higher reimbursement types of medical insurance [employee health insurance and commercial health (β = 0.03), government insurance (β = 0.04)] had higher hospice acceptance willingness, while males (β = -0.02) were less willing to accept than females. Psychological conditions [mild anxiety (β = 0.03), moderate anxiety (β = 0.01), moderate stress (β = 0.05), and severe stress (β = 0.06)] also played an important role. The Self-Management Scale (SHMS) (β = 0.12), EuroQol Five Dimensions Questionnaire (EQ-5D) (β = 0.05), EuroQol Visual Analog Scale (EQ-VAS) (β = 0.21), Short-Form Family Health Scale (FHS-SF) (β = 0.12), higher scores of the Short-Form Health Literacy Instrument (HLS-SF12) (β = 0.16), and Perceived Social Support Scale (PSSS) (β = 0.10) also contributed. Gender subgroup showed that in the male group, age, highest educational level, marital status, number of properties, whether having children, psychological conditions, the SHMS, EQ-5D, EQ-VAS, HLS-SF12, and PSSS showed significant difference. Urban and rural subgroups showed that age, highest educational level, number of properties, whether having chronic disease or psychological conditions, the SHMS, EQ-VAS, HLS-SF12, and PSSS were contributing factors in rural areas.
CONCLUSION
The average score of acceptance of hospice care was 65.02 points. Gender, house, anxiety, pressure, social support, and health literacy were the main influencing factors on residents' attitudes.
背景
2021 年，中国在死亡质量指数（Quality of Death Index）81 个国家中排名第 53 位。尽管对临终关怀的需求正在增加，但进展仍然缓慢。探索人们对临终关怀的接受程度及其相关影响因素具有重要意义。
方法
本研究于 2021 年 7 月 10 日至 9 月 15 日采用配额抽样法在中国进行了一项横断面调查。我们收集了人口统计学数据和临终关怀接受度。采用逐步线性回归分析。
结果
本调查共包含 11031 份有效问卷结果，以调查临终关怀的接受度。结果发现，具有本科及以上学历（β=0.04）、更多房产[2 套（β=0.02），3 套（β=0.01）]和更高类型的医疗保险报销[职工医疗保险和商业健康保险（β=0.03），政府保险（β=0.04）]的个体更愿意接受临终关怀，而男性（β=-0.02）比女性更不愿意接受临终关怀。心理状况[轻度焦虑（β=0.03），中度焦虑（β=0.01），中度压力（β=0.05）和重度压力（β=0.06）]也起着重要作用。自我管理量表（SHMS）（β=0.12），欧洲五维健康量表（EQ-5D）（β=0.05），EQ-视觉模拟量表（EQ-VAS）（β=0.21），家庭健康量表（FHS-SF）（β=0.12），短式健康素养量表 12 项（HLS-SF12）（β=0.16）和感知社会支持量表（PSSS）（β=0.10）也有贡献。性别亚组显示，在男性组中，年龄、最高教育水平、婚姻状况、房产数量、是否有子女、心理状况、SHMS、EQ-5D、EQ-VAS、HLS-SF12 和 PSSS 存在显著差异。城乡亚组显示，年龄、最高教育水平、房产数量、是否患有慢性病或心理状况、SHMS、EQ-VAS、HLS-SF12 和 PSSS 是农村地区的影响因素。
结论
临终关怀接受度的平均得分为 65.02 分。性别、住房、焦虑、压力、社会支持和健康素养是居民态度的主要影响因素。
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