Chih-Yuan Shih1, Wen-Yu Hu2, Shao-Yi Cheng3, Chien-An Yao3, Ching-Yu Chen4,3, Yen-Chun Lin3, Tai-Yuan Chiu3. 1. 1 Department of Family Medicine, National Taiwan University Hospital Jin-Shan Branch , New Taipei City, Taiwan . 2. 2 School of Nursing, College of Medicine and Hospital, National Taiwan University , Taipei, Taiwan . 3. 4 Department of Family Medicine, College of Medicine and Hospital, National Taiwan University , Taipei, Taiwan . 4. 3 Division of Gerontology Research, National Health Research Institutes , Zhunan, Miaoli County, Taiwan .
Abstract
BACKGROUND: Enabling people to die in their preferred place is important for providing high-quality end-of-life care. OBJECTIVE: The study objective was to explore patients' preferences regarding the place of end-of-life care and death and to compare these preferences with the perceptions of their family physicians. METHODS: This cross-sectional study used stratified random sampling, surveying 400 registered patients and 200 of their family physicians nationwide, with a five-part, structured, self-report questionnaire. RESULTS: Of the selected population, 310 patients (response rate 77.5%) and 169 physicians (response rate 84.5%) responded. Regarding the preferred place for end-of-life care, most of the patients would choose to receive care at home (60.6%) if home care services were available. Additionally, home was the most frequently preferred (66.5%) place of death. The family physicians' survey showed that a higher proportion of physicians selected home as the preferred place for end-of-life care and death (71.6% and 87.2%, respectively). The results of logistic regression analysis showed that patients younger than 50 years of age who believed in Chinese folk religion and who resided in a rural area were more likely to prefer to die at home. CONCLUSIONS: The most commonly preferred place for end-of-life care and death is the patient's home. Establishing a community-based palliative care system should be encouraged to allow more individuals to die in their preferred locations. There were discrepancies in the preferred place of end-of-life care and death between the patients' preferences and their family physicians' perceptions. More effective physician-patient communication regarding end-of-life care is needed.
BACKGROUND: Enabling people to die in their preferred place is important for providing high-quality end-of-life care. OBJECTIVE: The study objective was to explore patients' preferences regarding the place of end-of-life care and death and to compare these preferences with the perceptions of their family physicians. METHODS: This cross-sectional study used stratified random sampling, surveying 400 registered patients and 200 of their family physicians nationwide, with a five-part, structured, self-report questionnaire. RESULTS: Of the selected population, 310 patients (response rate 77.5%) and 169 physicians (response rate 84.5%) responded. Regarding the preferred place for end-of-life care, most of the patients would choose to receive care at home (60.6%) if home care services were available. Additionally, home was the most frequently preferred (66.5%) place of death. The family physicians' survey showed that a higher proportion of physicians selected home as the preferred place for end-of-life care and death (71.6% and 87.2%, respectively). The results of logistic regression analysis showed that patients younger than 50 years of age who believed in Chinese folk religion and who resided in a rural area were more likely to prefer to die at home. CONCLUSIONS: The most commonly preferred place for end-of-life care and death is the patient's home. Establishing a community-based palliative care system should be encouraged to allow more individuals to die in their preferred locations. There were discrepancies in the preferred place of end-of-life care and death between the patients' preferences and their family physicians' perceptions. More effective physician-patient communication regarding end-of-life care is needed.
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