Zhou Pei, Tang Cheng, Wang Jingyi, Zhang Chunhua, Zhong Jun
Zhongnan Hospital of Wuhan University, Hubei, China.
Department of Nursing, Zhongnan Hospital of Wuhan University, Hubei, China.
BMC Palliat Care. 2025 Jan 15;24(1):14. doi: 10.1186/s12904-025-01652-2.
Research on achieving a good death for terminally delirious patients is scarce, with limited knowledge about the level of good death and influencing factors. This study investigates the level of good death among delirium patients, factors influencing it, and the correlation between distress, end-of-life care needs, and achieving a good death by surveying bereaved family members of deceased patients in Chinese hospitals.
This cross-sectional study from January 2022 to January 2024 was conducted among bereaved family members of patients using an online questionnaire. The questionnaires consisted of (1) participants' demographic and disease-related questionnaires; (2) the Good Death Inventory (GDI) China version; (3) Terminal Delirium-Related Distress Scale (TTDS) China version; (4) the Care Evaluation Scale - short form (CES) China version. All data were analyzed using descriptive statistics, and the associated factors influencing good death were analyzed by multiple linear regression analyses.
A total of 263 subjects were enrolled. More males (63.5%) participated than females (36.5%), the mean age was 75.35 ± 13.90 years. Good quality of death was significantly and negatively related to the distress in patients with irreversible terminal delirium (r = -0.458, P<0.01).The multiple linear regression model indicates that TDDS score, CES score, types of diseases, smoking history, nutritional deficiency are important factor affecting the good quality of death.
The good quality of death from the perspective of bereaved family, a negative correlation was found between the distress in patients with irreversible terminal delirium and good death. Medical staff should be more aware of good quality of death in patients, future research should expand sample sizes to include more demographic data, and explore the concept of a good death across different cultural contexts.
关于为临终谵妄患者实现善终的研究很少，对善终水平及其影响因素的了解有限。本研究通过对中国医院已故患者的丧亲家属进行调查，探讨谵妄患者的善终水平、影响因素以及痛苦、临终护理需求与实现善终之间的相关性。
本横断面研究于2022年1月至2024年1月对患者的丧亲家属进行，采用在线问卷。问卷包括：（1）参与者的人口统计学和疾病相关问卷；（2）善终量表（GDI）中文版；（3）终末期谵妄相关痛苦量表（TTDS）中文版；（4）护理评估量表简表（CES）中文版。所有数据采用描述性统计进行分析，并通过多元线性回归分析影响善终的相关因素。
共纳入263名受试者。男性参与者（63.5%）多于女性（36.5%），平均年龄为75.35±13.90岁。不可逆终末期谵妄患者的死亡质量与痛苦显著负相关（r = -0.458，P<0.01）。多元线性回归模型表明，TTDS评分、CES评分、疾病类型、吸烟史、营养缺乏是影响死亡质量的重要因素。
从丧亲家属的角度来看，不可逆终末期谵妄患者的痛苦与善终之间存在负相关。医务人员应更加关注患者的善终质量，未来的研究应扩大样本量，纳入更多人口统计学数据，并探索不同文化背景下的善终概念。
