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ORIGINAL RESEARCH article
Front. Psychol.
Sec. Psychology for Clinical Settings
Volume 15 - 2024 |
doi: 10.3389/fpsyg.2024.1382272
The congruence between the preferred and actual place of death among terminal cancer patients in China
Provisionally accepted- 1 School of Nursing, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, China
- 2 Rory Meyers College of Nursing and NYU Aging Incubator, New York University, New York, United States
- 3 Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, China
- 4 Department of Nursing, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, China
Background: Dying in preferred place is important for good death. Nowadays, no study has evaluated the extent to which the preferences for the place of death (PoD) are met among terminal cancer patients in China. This study examined the congruence between the preferred and actual PoD and its predictors among terminal cancer patients in China.Methods: Between 2015 and 2023, 845 terminal cancer patients from four tertiary hospitals in Wuhan, China were enrolled and followed till death. Face-to-face survey at baseline and telephone-based interviews in the last month of patients' life were combined to learn patients' preferred PoD. Data on patients' actual PoD was collected from families within one month after patients' death.Results: Among the 410 patients who died, 62.7% of them died in hospitals. The agreement between patients' preferred and actual PoD was fair (𝜅=0.221). The congruence between patients' preferred and actual PoD were 63.0%, 36.6% and 0 for hospital death, home death, and hospice facility/nursing home death separately. Patients were more likely to die in their preferred places if their preferred place and family caregivers' belief of patients' preferred PoD was congruent (odds ratio [OR]=6.464, P=0.001), or caregivers had a medical related occupation (OR=4.577, P=0.003); if patients were hospitalized at least twice in the last month of life (OR=0.422, P=0.000), or the quality of care received by patients in the last 48 hours was rated good by the families (OR=0.373, P=0.011), patients were less likely to die in their preferred places.The congruence between patients' preferred and actual PoD was fair. Advance care planning needs to be popularized among China, and the quality of care in hospice facilities and nursing homes should be improved. Necessary policy support for hospice care should be made to respect cancer patients' end-of-life care preferences in mainland China.
Keywords: Cancer, Place of death, congruence, Hospice Care, Quality of death
Received: 20 Mar 2024; Accepted: 26 Aug 2024.
Copyright: © 2024 Lin, Ni, Wu, Liao and Fu. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Ping Ni, School of Nursing, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430074, Hubei Province, China
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