Determinants of Preference for Home Death among Terminally Ill Patients with Cancer in Taiwan: A Cross-Sectional Survey Study

Chen-Hsiu Chen; Yu-Chuan Lin; Li-Ni Liu; Siew-Tzuh Tang

doi:10.1097/jnr.0000000000000016

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医药卫生 > 预防保健与卫生学
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Determinants of Preference for Home Death among Terminally Ill Patients with Cancer in Taiwan: A Cross-Sectional Survey Study

台湾癌症末期病人死亡地点喜好之决定因素－横断性研究

陈贞秀(Chen-Hsiu Chen) ；林玉娟(Yu-Chuan Lin) ；刘莉妮(Li-Ni Liu) ；唐秀治(Siew-Tzuh Tang)

The Journal of Nursing Research ； 22 卷 1 期 (2014 / 03 / 01) ， P37 - 44

英文 DOI： 10.1097/jnr.0000000000000016

家中死亡的喜好；死亡地点的喜好；生命终期的照护；癌症末期病人； preference for home death ； preferred place of death ； end-of-life care ； terminally ill patients with cancer

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摘要 │ 参考文献 (28) │ 被引用文献 (2) │ 国际计量

摘要〈TOP〉

Background: Studies worldwide have shown that most patients with cancer prefer to die at home. Few studies have directly explored the determinants of preference for home death in patients with cancer living in Asia, and none has been conducted in Taiwan.Objectives: This study was designed to identify determinants of home-death preference among terminally ill patients with cancer in Taiwan.Methods: A convenience sample of 2,188 terminally ill patients with cancer from 24 hospitals nationwide was surveyed. This study used multivariate logistic regression analysis to identify the determinants of preference for home death in the realms of patient demographics and disease characteristics, awareness of prognosis, and family support.Results: Slightly more than half of the participants expressed the preference to die at home (n=1,114, 54.7%). The adjusted odds of preferring to die at home were greater for participants described by one or more of the following: (1) family members knew the participant's preference for place of death (p＜.001), (2) participant knew his or her prognosis (p=.032), (3) participant had greater functional dependency (p＜.001), (4) participant was diagnosed with either liver/pancreatic (p=.028) or head/neck (p=.012) cancer, and (5) participant had less than a junior high school education (p＜.001).Conclusions/Implications for Practice: This study supports the argument that most terminally ill patients with cancer in Taiwan prefer to die at home. To achieve patient preferences for home death, healthcare professionals should provide prognostic information and initiate end-of-life care discussions among patients and their family to facilitate family understanding of their ill relative's place-of-death preference. Developing clinical interventions to alleviate physical symptoms and providing hospice homecare services for terminally ill patients with cancer, especially those with lung cancer and greater functional dependency, may facilitate a preference for and actualization of home death.

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参考文献 ( 28 ) 〈TOP〉

Department of Statistics, Ministry of the Interior, Taiwan, ROC. (2008). Education level of Taiwanese older than 15 years of age. Retrieved from http://www.moi.gov.tw/files/news_file/week9716.doc (Original work published in Chinese)
Department of Statistics, Ministry of the Interior, Taiwan, ROC. (2005). Survey of the elderly 2005. Retrieved from http://sowf.moi.gov.tw/stat/Survey/94old.doc (Original work published in Chinese)
Aabom, B.,Kragstrup, J.,Vondeling, H.,Bakketeig, L. S.,Stovring, H.(2005).Defining cancer patients as being in the terminal phase: Who receives a formal diagnosis, and what are the effects?.Journal of Clinical Oncology,23(30),7411-7416.
Alonso-Babarro, A.,Bruera, E.,Varela-Cerdeira, M.,Boya-Cristia, M. J.,Madero, R.,Torres-Vigil, I.,González-Barón, M.(2011).Can this patient be discharged home? Factors associated with at-home death among patients with cancer.Journal of Clinical Oncology,29(9),1159-1167.
Bakitas, M.,Ahles, T. A.,Skalla, K.,Brokaw, F. C.,Byock, I.,Hanscom, B.,Hegel, M. T.(2008).Proxy perspectives regarding end-of-life care for persons with cancer.Cancer,112(8),1854-1861.

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