Purpose: This study aims to understand how elderly patients with advanced cancer and their families make a decision for a place of death for the patient. Methods: Semi-structured interviews were conducted with 17 pair...Purpose: This study aims to understand how elderly patients with advanced cancer and their families make a decision for a place of death for the patient. Methods: Semi-structured interviews were conducted with 17 pairs of elderly patients and members of their family. The patients had finished anticancer treatment and made some decision about the preferred place of death. A modified grounded-theory approach was used for the data analysis. Results: Making a “tentative” decision for the place of death of the elderly patients is a process with the core category [carefully choosing the final place for self-fulfillment]. The patients were “conducting a comprehensive review of the place of death” and “embracing the wishes for a way of life without difficulty”. Involving the family in making a “tentative” decision about the place of death of the elderly patients is the process with the core category [realizing the wish of patients in the terminal condition for the way for death]. The families were “examining the place of death from different aspects” and “respecting the patient’s intention as far as possible”. Conclusions: When the patients [carefully choosing the final place for self-fulfillment], it was important to reconcile their wishes with the burden on the families. When the families were trying to [realize the wish of patients in the terminal condition for the way for dying], it was important to balance the respect for the patient intentions and homecare they can provide for the patient. For the patients and their families, it is essential to mutually understand the intentions and wishes of the other party in decision making about the place of death.展开更多
Background:Studies that comprehensively address the characteristics of centenarian deaths are rare.The present study aimed to depict the characteristics of centenarian deaths in China and their changing trends.Methods...Background:Studies that comprehensively address the characteristics of centenarian deaths are rare.The present study aimed to depict the characteristics of centenarian deaths in China and their changing trends.Methods:Data on centenarian deaths between 2013 and 2020 were obtained from the national mortality surveillance system of China,including date,place of death(PoD),and underlying cause of death(CoD).Descriptive analyses were performed to understand the epidemiological characteristics,and a joinpoint regression model was adopted to examine the changing trends in the proportions of different PoDs,CoDs among centenarians,and centenarian deaths accounting for all deaths and deaths among people aged 65 years and older.Results:There were 46,938 registered centenarian deaths between 2013 and 2020 that included 34,311 females(73.10%)and 12,627 males(26.90%).January(12.05%),February(9.99%),and December(9.74%)were the top three months with the highest number of deaths.The proportions of deaths that occurred in homes,hospitals,and nursing homes were 81.71%,13.63%,and 2.68%,respectively.The proportion of deaths in nursing homes increased by 9.60%(95%confidence intervals[CIs],6.4-12.9%)from 2014 to 2020.Heart disease(35.72%)was the leading cause of death,followed by respiratory diseases(17.63%),cerebrovascular disease(15.60%),and old age(11.22%).The proportion of respiratory diseases decreased by 4.8%(95%CI,-8.8 to-0.7%),and the proportion of deaths from old age decreased by 2.3%(95%CI,-4.4 to-0.1%)per year.Shanghai had the highest proportions of deaths in hospitals(39.38%)and nursing homes(14.68%).Sichuan had the highest proportion of deaths attributed to respiratory diseases(32.30%),while Jiangsu(26.58%)and Zhejiang(23.61%)had the highest proportions of deaths from old age.Conclusion:Unlike other countries,centenarian deaths in China are characterized by a higher proportion of home and heart disease deaths,and this death pattern differs across provinces.展开更多
文摘Purpose: This study aims to understand how elderly patients with advanced cancer and their families make a decision for a place of death for the patient. Methods: Semi-structured interviews were conducted with 17 pairs of elderly patients and members of their family. The patients had finished anticancer treatment and made some decision about the preferred place of death. A modified grounded-theory approach was used for the data analysis. Results: Making a “tentative” decision for the place of death of the elderly patients is a process with the core category [carefully choosing the final place for self-fulfillment]. The patients were “conducting a comprehensive review of the place of death” and “embracing the wishes for a way of life without difficulty”. Involving the family in making a “tentative” decision about the place of death of the elderly patients is the process with the core category [realizing the wish of patients in the terminal condition for the way for death]. The families were “examining the place of death from different aspects” and “respecting the patient’s intention as far as possible”. Conclusions: When the patients [carefully choosing the final place for self-fulfillment], it was important to reconcile their wishes with the burden on the families. When the families were trying to [realize the wish of patients in the terminal condition for the way for dying], it was important to balance the respect for the patient intentions and homecare they can provide for the patient. For the patients and their families, it is essential to mutually understand the intentions and wishes of the other party in decision making about the place of death.
基金National Natural Science Foundation of China(No.81941025)
文摘Background:Studies that comprehensively address the characteristics of centenarian deaths are rare.The present study aimed to depict the characteristics of centenarian deaths in China and their changing trends.Methods:Data on centenarian deaths between 2013 and 2020 were obtained from the national mortality surveillance system of China,including date,place of death(PoD),and underlying cause of death(CoD).Descriptive analyses were performed to understand the epidemiological characteristics,and a joinpoint regression model was adopted to examine the changing trends in the proportions of different PoDs,CoDs among centenarians,and centenarian deaths accounting for all deaths and deaths among people aged 65 years and older.Results:There were 46,938 registered centenarian deaths between 2013 and 2020 that included 34,311 females(73.10%)and 12,627 males(26.90%).January(12.05%),February(9.99%),and December(9.74%)were the top three months with the highest number of deaths.The proportions of deaths that occurred in homes,hospitals,and nursing homes were 81.71%,13.63%,and 2.68%,respectively.The proportion of deaths in nursing homes increased by 9.60%(95%confidence intervals[CIs],6.4-12.9%)from 2014 to 2020.Heart disease(35.72%)was the leading cause of death,followed by respiratory diseases(17.63%),cerebrovascular disease(15.60%),and old age(11.22%).The proportion of respiratory diseases decreased by 4.8%(95%CI,-8.8 to-0.7%),and the proportion of deaths from old age decreased by 2.3%(95%CI,-4.4 to-0.1%)per year.Shanghai had the highest proportions of deaths in hospitals(39.38%)and nursing homes(14.68%).Sichuan had the highest proportion of deaths attributed to respiratory diseases(32.30%),while Jiangsu(26.58%)and Zhejiang(23.61%)had the highest proportions of deaths from old age.Conclusion:Unlike other countries,centenarian deaths in China are characterized by a higher proportion of home and heart disease deaths,and this death pattern differs across provinces.
