Aryal Komal, Jones Aaron, Tanuseputro Peter, Griffith Lauren E, Hebert Paul C, Kirkland Susan, Cook Deborah J, Costa Andrew P
Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada.
St. Joseph's Health System Centre for Integrated Care, Hamilton, Ontario, Canda.
PLoS One. 2025 Jan 24;20(1):e0317014. doi: 10.1371/journal.pone.0317014. eCollection 2025.
Death is universal, yet relatively little is known about how Canadians experience their death. Using novel decedent interview data from the Canadian Longitudinal Study on Aging we describe the prevalence and characteristics of peace with dying among older Canadians.
We conducted a secondary analysis of decedent interview data from the Canadian Longitudinal Study on Aging. Proxies of deceased Canadian Longitudinal Study on Aging participants reported on participants' end-of-life experiences between January 2012 to March 2022. We examined end-of-life characteristics and their association with proxy reports of experiencing peace with dying. We conducted regression analysis to explore the association between demographic and end-of-life characteristics and experiencing peace with dying.
Of 3,672 deceased participants, 1,287 (35.0%) had a completed decedent questionnaire and were included in the analysis. Respondents reported that two-thirds (66.0%) of the deceased experienced peace with dying and 17% did not experience peace with dying. The unadjusted odds of experiencing peace with dying were higher for those with an appointed power of attorney (OR 1.80; CI 1.39-2.33), those who died of cancer (OR 1.71; CI 1.27-2.30), those in hospice/receiving palliative care (OR 1.67; CI 1.19-2.37), individuals older than 75 years (OR 1.55; CI 1.04-2.30), or widowed (OR 1.53; CI 1.12-2.10). Widowhood (OR 1.51; CI 1.01-2.29), having an end-of-life SDM (OR 1.58; CI 1.14-2.17), and dying of cancer (OR 1.67; CI 1.19-2.23) increased the adjusted odds of dying with peace.
Close to 1 in 5 older Canadians may not experience peace with dying, which supports greater focus on improving the end-of-life care. Our findings suggest that advanced planning may enhance the experience of a peaceful death in Canada.
死亡是普遍存在的，但对于加拿大人如何面对自己的死亡，我们了解得相对较少。利用加拿大老龄化纵向研究中的新型死者访谈数据，我们描述了加拿大老年人临终时内心平静的患病率及特征。
我们对加拿大老龄化纵向研究中的死者访谈数据进行了二次分析。加拿大老龄化纵向研究参与者的代理人报告了2012年1月至2022年3月期间参与者的临终经历。我们研究了临终特征及其与临终时内心平静的代理人报告之间的关联。我们进行了回归分析，以探讨人口统计学和临终特征与临终时内心平静之间的关联。
在3672名已故参与者中，1287名（35.0%）完成了死者调查问卷并纳入分析。受访者报告称，三分之二（66.0%）的死者临终时内心平静，17%的死者临终时内心不平静。拥有指定代理人的人（比值比1.80；可信区间1.39 - 2.33）、死于癌症的人（比值比1.71；可信区间1.27 - 2.30）、在临终关怀机构/接受姑息治疗的人（比值比1.67；可信区间1.19 - 2.37）、75岁以上的人（比值比1.55；可信区间1.04 - 2.30）或丧偶者（比值比1.53；可信区间1.12 - 2.10），临终时内心平静的未调整比值较高。丧偶（比值比1.51；可信区间1.01 - 2.29）、有临终共享决策（比值比1.58；可信区间1.14 - 2.17）以及死于癌症（比值比1.67；可信区间1.19 - 2.23）会增加临终时内心平静的调整后比值。
近五分之一的加拿大老年人临终时可能内心不平静这一情况，支持更关注改善临终护理。我们的研究结果表明，提前规划可能会提升加拿大平静死亡的体验。
