Varalak Srinonprasert1, Manchumad Manjavong2, Panita Limpawattana3, Verajit Chotmongkol4, Srivieng Pairojkul5, Jarin Chindaprasirt6, Kongpob Yongrattanakit7, Sawadee Kaiyakit7, Thitikorn Juntararuangtong7, Thunchanok Kuichanuan7. 1. Division of Geriatric Medicine, Department of Internal Medicine, Siriraj Hospital, Faculty of Medicine, Mahidol University, Thailand. 2. Division of Geriatric Medicine, Department of Internal Medicine, Faculty of Medicine, Khon Kaen University, Thailand. 3. Division of Geriatric Medicine, Department of Internal Medicine, Faculty of Medicine, Khon Kaen University, Thailand. Electronic address: lpanit@kku.ac.th. 4. Division of Neurology, Department of Internal Medicine, Faculty of Medicine, Khon Kaen University, Thailand. 5. Palliative care unit, Faculty of Medicine, Khon Kaen University, Thailand. 6. Division of Oncology Medicine, Department of Internal Medicine, Faculty of Medicine, Khon Kaen University, Thailand. 7. Residency training in Department of Internal Medicine, Faculty of Medicine, Khon Kaen University, Thailand.
Abstract
BACKGROUND: Goal of palliative care is to experience a good death. Understanding the perceptions of elderly patients and their relatives about this issue should provide healthcare professionals with practical guidance in order to achieve this goal. OBJECTIVES: To determine and compare the perceptions of elderly patients and relatives regarding wishes during their end-of-life(EOL) period. METHODS: This was a cross-sectional study conducted at Siriraj and Srinagarind Hospital in Thailand from September 2017 to February 2018. A questionnaire was given to elderly patients and the relatives of them. The patients were asked to respond to the questions as though they were terminally-ill patients, and relatives were asked to imagine how elderly people would respond to the questions. RESULTS: We recruited 608 elderly patients and 607 relatives. The most important issue in both groups was"receiving the full truth about their illnesses". The perceptions of the patients and relatives differed significantly in 8/13 areas covered in the questionnaire. Independent factors associated with preference for home death were elderly from Khon Kaen (adjusted odds ratio (AOR) 2.6;95%CI 1.7,4.1), previous self-employed/general work compared to individuals who did not work (AOR 0.5;95%CI 0.3,0.9), low educational level (AOR 2.3;95%CI 1.3,4.0), low income (AOR 1.7;95%CI 1.1,2.5), greater family size (AOR 1.7;95%CI 1.1,2.6) and dissatisfaction in life (AOR 2.5;95%CI 1.1,5.4). CONCLUSION: Receiving the full truth about their illnesses was the most important issue for participants in both groups. The major differences between the two groups had to do with autonomy. Factors influencing place of death were location of patients, previous occupation, educational level, family income, family size and dissatisfaction in life.
BACKGROUND: Goal of palliative care is to experience a good death. Understanding the perceptions of elderly patients and their relatives about this issue should provide healthcare professionals with practical guidance in order to achieve this goal. OBJECTIVES: To determine and compare the perceptions of elderly patients and relatives regarding wishes during their end-of-life(EOL) period. METHODS: This was a cross-sectional study conducted at Siriraj and Srinagarind Hospital in Thailand from September 2017 to February 2018. A questionnaire was given to elderly patients and the relatives of them. The patients were asked to respond to the questions as though they were terminally-ill patients, and relatives were asked to imagine how elderly people would respond to the questions. RESULTS: We recruited 608 elderly patients and 607 relatives. The most important issue in both groups was"receiving the full truth about their illnesses". The perceptions of the patients and relatives differed significantly in 8/13 areas covered in the questionnaire. Independent factors associated with preference for home death were elderly from Khon Kaen (adjusted odds ratio (AOR) 2.6;95%CI 1.7,4.1), previous self-employed/general work compared to individuals who did not work (AOR 0.5;95%CI 0.3,0.9), low educational level (AOR 2.3;95%CI 1.3,4.0), low income (AOR 1.7;95%CI 1.1,2.5), greater family size (AOR 1.7;95%CI 1.1,2.6) and dissatisfaction in life (AOR 2.5;95%CI 1.1,5.4). CONCLUSION: Receiving the full truth about their illnesses was the most important issue for participants in both groups. The major differences between the two groups had to do with autonomy. Factors influencing place of death were location of patients, previous occupation, educational level, family income, family size and dissatisfaction in life.