O'Sullivan Anna, Larsdotter Cecilia, Sawatzky Richard, Alvariza Anette, Imberg Henrik, Cohen Joachim, Öhlén Joakim
Department of Nursing Science, Sophiahemmet University, Stockholm, Sweden
Department of Health Care Sciences, Marie Cederschiold Hogskola-Campus Ersta, Stockholm, Sweden.
BMJ Support Palliat Care. 2024 Dec 19;14(e3):e2904-e2913. doi: 10.1136/spcare-2023-004697.
The aim was: (1) to investigate preferred place for end-of-life care and death for bereaved family members who had recently lost a person with advanced illness and (2) to investigate associations between bereaved family members' preferences and individual characteristics, health-related quality of life, as well as associations with their perception of the quality of care that the ill person had received, the ill person's preferred place of death and involvement in decision-making about care.
A cross-sectional survey with bereaved family members, employing descriptive statistics and multinominal logistic regression analyses.
Of the 485 participants, 70.7% were women, 36.1% were ≥70 years old, 34.5% were partners and 51.8% were children of the deceased. Of the bereaved family members, 52% preferred home for place of end-of-life care and 43% for place of death. A higher likelihood of preferring inpatient palliative care was associated with being female and having higher education, whereas a lower likelihood of preferring a nursing home for the place of care and death was associated with higher secondary or higher education. Partners were more likely to prefer hospital for place of care and nursing home for place of death.
Home was the most preferred place for end-of-life care and death. Bereaved people's experiences of end-of-life care may impact their preferences, especially if they had a close relationship, such as a partner who had a higher preference for nursing home and hospital care. Conversations about preferences for the place of care and death considering previous experience are encouraged.
本研究旨在:(1)调查近期失去晚期疾病患者的丧亲家庭成员对于临终关怀和死亡地点的偏好;(2)调查丧亲家庭成员的偏好与个体特征、健康相关生活质量之间的关联,以及与他们对患病者所接受的护理质量的认知、患病者的首选死亡地点和护理决策参与度之间的关联。
对丧亲家庭成员进行横断面调查,采用描述性统计和多项逻辑回归分析。
在485名参与者中,70.7%为女性,36.1%年龄≥70岁,34.5%为伴侣,51.8%为死者的子女。在丧亲家庭成员中,52%倾向于在家中接受临终关怀,43%倾向于在家中死亡。女性和受教育程度较高者更倾向于选择住院姑息治疗,而中等教育程度或以上者选择养老院作为护理和死亡地点的可能性较低。伴侣更倾向于选择医院作为护理地点,选择养老院作为死亡地点。
家是最受欢迎的临终关怀和死亡地点。丧亲者的临终关怀经历可能会影响他们的偏好,特别是如果他们关系密切,例如伴侣对养老院和医院护理有更高的偏好。鼓励就考虑既往经历的护理和死亡地点偏好进行对话。