Preferences for a good death: a cross-sectional survey in advanced cancer patients

Abstract

ObjectiveThe aim of this study was to describe preferences for a good death among Chinese patients with advanced cancer and then to explore factors contributing to their preferences including patient demographics and disease variables.MethodsA convenience sample of 275 patients with advanced cancer was recruited from a tertiary cancer hospital in Beijing, China, between February and December 2017. A Chinese version of the Good Death Inventory (GDI) was used to measure patients’ preferences for dying and death. Besides, data were collected using a multi-itemed questionnaire focusing on demographic and disease characteristics of patients.ResultsOf the 275 questionnaires returned, 248 responses were analysed (effective response rate 90.2%). According to the total scores for each of the 20 domains, the five most important domains of a good death were: good relationship with family (19.80±2.39), independence (19.66±2.56), maintaining hope and pleasure (19.56±2.55), good relationship with medical staff (18.92±3.73), not being a burden to others (18.89±3.30). Patients’ characteristics including age, educational status, religious belief, medical payment types, family economic status, past experiences of the death of others, the period since cancer diagnosis, past experiences of hospitalisation and subjective physical condition influenced their preferences for a good death (all p<0.05).ConclusionsWe had an in-depth knowledge and understanding of their preferences for good death among Chinese patients with advanced cancer. Meanwhile, we found some patients’ factors contributed to different preferences for a good death. These findings have the potential to guide hospice care services aimed at achieving a good death for patients with advanced cancer.

Identifying End-of-Life Preferences Among Chinese Patients With Cancer Using the Heart to Heart Card Game

“…“I want my family to get along” and “I don’t want to be a burden to my family” were both most frequently selected EOL preferences in this study. Consistent with past findings, this result highlights the importance of family in the EOL care for Chinese patients 20,21 since family support constitutes the major aspect of social support for patients in China. 22 This family support is unique to the concept of filial piety in the Chinese culture that advocates the responsibility of mutual caring, loving, and giving among blood relations.…”

Nurse‐rated good death of Chinese terminally ill patients with cancer: A cross‐sectional study

“…The percentage of achievement of good death in these three domains was higher than 80%. These findings were consistent with the preference of Chinese general public and healthcare providers for a good death (Huang et al, ), especially the survey in advanced cancer patients in ‘Good relationship with medical staff’ and ‘Good relationship with family’ (Hou et al, ). Despite people of different cultural backgrounds, this study proved there were similar to attributes of a good death of Westerners included beliefs and values honoured, relationships optimised and family care (Kehl, ).…”

“…It was considered realised in a large proportion of the patients (more than 85%). The results also meet the expectations of the advanced cancer patients as Hou et al () reminded us. It suggests that oncology inpatient wards provide the dying patient not only environmental comfort but also whole person care.…”

“…It got the lowest score and rate of achievement in all optional domains. It is agreement with the unimportance of ‘Religious and spiritual comfort’ in advanced cancer patients’ preferences for a good death (Hou et al, ), but against over most of Americans believing that ‘being at peace with God’ and ‘prayer’ were important’ (Steinhauser, Christakis, et al, ). There were only 5 cases reported religious patients in this study.…”

Mental Adjustment as a Predictor of Comprehensive Quality of Life Outcome among Patients with Terminal Cancer

“…This study indicated that patients’ mental adjustment, economic status, perceived disease severity, PPI, and symptom severity directly affect their CoQoLO. It is not surprising that patients’ or families’ economic status would facilitate good CoQoLO [ 43 ] due to higher spiritual burden [ 44 ]. The perception of one’s disease severity, and not the actual disease state, tended to relate to a patient’s psychological well-being.…”