Prevalence, Effectiveness, and Predictors of Planning the Place of Death Among Older Persons Followed in Community‐Based Long Term Care

Leff, Bruce; Kaffenbarger, Kimberly P.; Remsburg, Robin E.

doi:10.1111/j.1532-5415.2000.tb06892.x

Cited by 33 publications

(54 citation statements)

References 14 publications

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“…Nine studies focused on congruence specifically3, 14, 27–32, 34 and nine examined preference as one of many factors associated with place of death 10, 12, 17–19, 33, 35–37. Seven studies were from the U.S.,3, 10, 12, 19, 28, 30, 35 three were from the U.K.,27, 33, 34 and four were from Canada 17, 18, 32, 37. Australia,14 Sweden,36 Taiwan29 and Italy31 each had one study included.…”

Section: Resultsmentioning

confidence: 99%

Factors Associated with Congruence Between Preferred and Actual Place of Death

Bell

Somogyi-Zalud

Masaki

2010

Journal of Pain and Symptom Management

132

126

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Congruence between preferred and actual place of death may be an essential component in terminal care. Most patients prefer a home death, but many patients do not die in their preferred location. Specialized (physician, hospice and palliative) home care visits may increase home deaths, but factors associated with congruence have not been systematically reviewed. This study sought to review the extent of congruence reported in the literature, and examine factors that may influence congruence. In July 2009, a comprehensive literature search was performed using MEDLINE, Psych Info, CINAHL, and Web of Science. Reference lists, related articles, and the past five years of six palliative care journals were also searched. Overall congruence rates (percentage of met preferences for all locations of death) were calculated for each study using reported data to allow cross-study comparison. Eighteen articles described 30% to 91% congruence. Eight specialized home care studies reported 59% to 91% congruence. A physician-led home care program reported 91% congruence. Of the 10 studies without specialized home care for all patients, seven reported 56% to 71% congruence and most reported unique care programs. Of the remaining three studies without specialized home care for all patients, two reported 43% to 46% congruence among hospital inpatients, and one elicited patient preference "if everything were possible," with 30% congruence. Physician support, hospice enrollment, and family support improved congruence in multiple studies. Research in this important area must consider potential sources of bias, the method of eliciting patient preference, and the absence of a single ideal place of death.

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Section: Resultsmentioning

confidence: 99%

Factors Associated with Congruence Between Preferred and Actual Place of Death

Bell

Somogyi-Zalud

Masaki

2010

Journal of Pain and Symptom Management

132

126

View full text Add to dashboard Cite

show abstract

“…The lowest overall congruence and kappa statistic were reported in a grade A study that prospectively elicited patients' preferences 'if everything were possible,' 23 while the study with the highest congruence and kappa statistic were reported in a grade B retrospective chart review of a physician-led house call programme. 26 Among the higher quality prospective studies, three longitudinal studies which reported the patient's final preference prior to death 6,24,25 yielded higher congruence and kappa statistics Table 2 Examples of tables reporting congruence between preferred and actual places of death than the studies that elicited patients' preferences at one point in time. 18,19,23 One study reported a 70% overall congruence, yet the kappa statistic was only 0.17 due to correction for chance agreement based on the distribution of the preferences and places of death.…”

Section: Methods Of Reporting Congruencementioning

confidence: 95%

Methodological review: measured and reported congruence between preferred and actual place of death

Somogyi-Zalud

2009

Palliat Med

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Congruence between preferred and actual place of death is an important palliative care outcome reported in the literature. We examined methods of measuring and reporting congruence to highlight variations impairing cross-study comparisons. Medline, PsychInfo, CINAHL, and Web of Science were systematically searched for clinical research studies examining patient preference and congruence as an outcome. Data were extracted into a matrix, including purpose, reported congruence, and method for eliciting preference. Studies were graded for quality. Using tables of preferred versus actual places of death, an overall congruence (total met preferences out of total preferences) and a kappa statistic of agreement were determined for each study. Twelve studies were identified. Percentage of congruence was reported using four different definitions. Ten studies provided a table or partial table of preferred versus actual deaths for each place. Three studies provided kappa statistics. No study achieved better than moderate agreement when analysed using kappa statistics. A study which elicited ideal preference reported the lowest agreement, while longitudinal studies reporting final preferred place of death yielded the highest agreement (moderate agreement). Two other studies of select populations also yielded moderate agreement. There is marked variation in methods of eliciting and reporting congruence, even among studies focused on congruence as an outcome. Cross-study comparison would be enhanced by the use of similar questions to elicit preference, tables of preferred versus actual places of death, and kappa statistics of agreement.

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“…In a US study, 87.2% of the dying preferred a death at home (cancer patients), 4 so did 74% in a Taiwanese study (cancer patients), 13 93.5% in an Italian study (cancer patients), 14 and 82.5% in another US study. 15 A further study from South Australia, interviewing the general population concerning preferred places of death, showed that 70% wanted to die at home if hypothetically dying of a terminal illness. 16 These findings reaffirm the importance of a familiar surrounding and the continuous presence of family and loved ones for the dying.…”

Section: Relevance Of the Findings And Implicationsmentioning

confidence: 98%