Bornet Marc-Antoine, Jones Laura, Jox Ralf J, Bernard Mathieu, Ruedin Samira, Borasio Gian Domenico, Rubli Truchard Eve
Chair of Geriatric Palliative Care, Palliative and Supportive Care Service and Service of Geriatric Medicine and Geriatric Rehabilitation, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland.
Palliative and Supportive Care Service, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland.
Palliat Support Care. 2024 Oct;22(5):932-937. doi: 10.1017/S1478951523000044.
While there is a growing body of literature on the wish to die in older patients, there is little research about their will to live. Exploring the subjective will to live (WTL) offers valuable insights into the patients' resources and motivations, which could help improving geriatric palliative care. The aim of this study was to examine, in long-term care facilities (LTCF), residents' definitions of and factors influencing their WTL.
Twenty residents (mean age 85.8 ± 10.3 years, 70% women) of 3 Swiss LTCFs gave informed consent and participated in semi-structured interviews about their WTL. Interviews were audio-recorded and transcribed verbatim. Thematic analysis was conducted to identify recurrent themes (40% double coded).
The majority of residents reported that they had not thought about the WTL. Nevertheless, they had no difficulty in describing it as innate in their lives. They spontaneously mentioned factors that contributed to their WTL, classified into 5 themes: (1) relationships - primarily with family and health professionals, secondarily with other residents; (2) living situation - the LTCF as a necessary place providing care, constant professional presence, and security, yet necessitates inconveniences such as loss of independence; (3) personality factors - positive outlook on life or spirituality; (4) engagement in routines - organized activities and individual daily routines; and (5) health status - primarily related to functional health.
Examining WTL provides important insights into elements that are essential to take into account in planning care and promoting well-being in LTCF residents. The themes identified provide important starting points for improving life in LTCFs.
虽然关于老年患者求死意愿的文献越来越多，但关于他们求生意愿的研究却很少。探索主观求生意愿（WTL）能为了解患者的资源和动机提供有价值的见解，这有助于改善老年姑息治疗。本研究的目的是在长期护理机构（LTCF）中，考察居民对其求生意愿的定义以及影响求生意愿的因素。
瑞士3家长期护理机构的20名居民（平均年龄85.8±10.3岁，70%为女性）签署知情同意书，参与了关于其求生意愿的半结构式访谈。访谈进行了录音并逐字转录。进行了主题分析以识别反复出现的主题（40%进行了双重编码）。
大多数居民报告称他们没有思考过求生意愿。然而，他们毫不费力地将其描述为生活中与生俱来的。他们自发提到了有助于其求生意愿的因素，分为5个主题：（1）人际关系——主要是与家人和医护人员，其次是与其他居民；（2）生活状况——长期护理机构是提供护理、有持续专业人员在场和安全感的必要场所，但也带来了诸如失去独立性等不便；（3）个性因素——对生活的积极态度或精神信仰；（4）日常活动参与——有组织的活动和个人日常活动；（5）健康状况——主要与功能健康有关。
考察求生意愿为规划长期护理机构居民的护理和促进其福祉时必须考虑的要素提供了重要见解。所确定的主题为改善长期护理机构的生活提供了重要的起点。
