普通患者对癌症终末治疗和死亡的态度及其影响因素

The investigation on non-cancer patients＇ attitudes towards terminal cancer treatment and death and the influential factor

目的了解普通患者对癌症终末治疗和死亡的态度及其影响因素，为癌症终末治疗抉择以及死亡教育的开展提供科学依据。方法采用自制调查问卷，对307例门诊普通患者进行调查。结果有226例占73．6％的患者不介意谈论死亡的相关问题，对癌症终末期实施“临终关怀”“安乐死”和建立“治疗遗愿”等的评分超过3．8分；Logistic回归分析显示，城市居民更倾向于赞同淡化治疗，实施安乐死和建立治疗遗愿；年长者更倾向于赞同“实施安乐死”“思考死亡相关问题后更加热爱生活”，以及“公开和家人谈论死亡”，其差异均有统计学意义。结论“临终关怀”和“安乐死”等生命伦理学观念正逐步为普通民众所接受，但实现由“治疗”向“照护”的转变，还需要营造一个对死亡更加开明的氛围，需要不断缩小城乡差别，需要早期进行死亡教育。

Objective to learn the non-cancer patients＇ attitude towards terminal cancer treatment and death , and influential factor. Provide scientific basis for the choice of terminal cancer treatment and death education. Methods 307 non-cancer patients in common clicnic were investigated by a self-designed questionnaire. Results 73.6% of the patients didn＇ t mind talking about death, the score they gave to such items as ＂hospice care＂, ＂making a will of treatment＂ and ＂euthanasia＂ was more than 3.8. The Logistic Regression analysis suggested that city residents tend to approve of ＂ hospice care＂, ＂ making a will of treatment＂ and ＂euthanasia＂; the elder people tend to approve of ＂euthanasia＂, more love for life after thinking of death-related issues＂ and ＂talking about death with family members openly＂. The discrepancies were statistically significant. Conclusions The bioethical concepts such as ＂hospice care＂, ＂euthanasia＂ are being gradually accepted by the public. To achieve the transition from a ＂cure＂ to ＂care＂, we still should make an effort to build a more open atmosphere for death, reduce the differences between urban and rural areas and carry out death education earlier.