Abstract
Purpose
Understanding the concept of a “good death” is crucial to end-of-life care, but our current understanding of what constitutes a good death is insufficient. Here, we investigated the components of a good death that are important to the general population, cancer patients, their families, and physicians.
Methods
We conducted a stratified nationwide cross-sectional survey of cancer patients and their families from 12 hospitals, physicians from 12 hospitals and the Korean Medical Association, and the general population, investigating their attitudes toward 10 good-death components.
Findings
Three components—“not be a burden to the family,” “presence of family,” and “resolve unfinished business”—were considered the most important components by more than 2/3 of each of the three groups, and an additional three components—“freedom from pain,” “feel that life was meaningful,” and “at peace with God”—were considered important by all but the physicians group. Physicians considered “feel life was meaningful,” “presence of family,” and “not be a burden to family” as the core components of a good death, with “freedom from pain” as an additional component. “Treatment choices’ followed, “finances in order,” “mentally aware,” and “die at home” were found to be the least important components among all four groups.
Conclusion
While families strongly agreed that “presence of family” and “not be a burden to family” were important to a good death, the importance of other factors differed between the groups. Health care providers should attempt to discern each patient’s view of a good death.
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Change history
16 July 2019
While recently extending that research, however, we discovered that 236 members of the general population were mistakenly duplicated by the investigating agency (Word Research) and 1241 were reported rather than 1005. Here, we present corrections and discuss the relevant data.
16 July 2019
While recently extending that research, however, we discovered that 236 members of the general population were mistakenly duplicated by the investigating agency (Word Research) and 1241 were reported rather than 1005. Here, we present corrections and discuss the relevant data.
References
Cottrell L, Duggleby W (2016) The “good death”: an integrative literature review. Palliat Support Care 14(6):686–712. https://doi.org/10.1017/S1478951515001285
Rietjens JA, van der Heide A, Onwuteaka-Philipsen BD, van der Maas PJ, van der Wal G (2006) Preferences of the Dutch general public for a good death and associations with attitudes towards end-of-life decision-making. Palliat Med 20(7):685–692. https://doi.org/10.1177/0269216306070241
Cheng SY, Hu WY, Liu WJ, Yao CA, Chen CY, Chiu TY (2008) Good death study of elderly patients with terminal cancer in Taiwan. Palliat Med 22(5):626–632. https://doi.org/10.1177/0269216307087142
Miyashita M, Kawakami S, Kato D, Yamashita H, Igaki H, Nakano K, Kuroda Y, Nakagawa K (2015) The importance of good death components among cancer patients, the general population, oncologists, and oncology nurses in Japan: patients prefer “fighting against cancer”. Support Care Cancer 23(1):103–110. https://doi.org/10.1007/s00520-014-2323-z
Tsai JS, Wu CH, Chiu TY, Hu WY, Chen CY (2005) Fear of death and good death among the young and elderly with terminal cancers in Taiwan. J Pain Symptom Manag 29(4):344–351. https://doi.org/10.1016/j.jpainsymman.2004.07.013
Cagle JG, Pek J, Clifford M, Guralnik J, Zimmerman S (2015) Correlates of a good death and the impact of hospice involvement: findings from the national survey of households affected by cancer. Support Care Cancer: Off J Multinatl Assoc Support Care Cancer 23(3):809–818. https://doi.org/10.1007/s00520-014-2404-z
Spathis A, Booth S (2008) End of life care in chronic obstructive pulmonary disease: in search of a good death. Int J Chron Obstruct Pulmon Dis 3(1):11–29
Haishan H, Hongjuan L, Tieying Z, Xuemei P (2015) Preference of Chinese general public and healthcare providers for a good death. Nurs Ethics 22(2):217–227. https://doi.org/10.1177/0969733014524760
Leung KK, Tsai JS, Cheng SY, Liu WJ, Chiu TY, Wu CH, Chen CY (2010) Can a good death and quality of life be achieved for patients with terminal cancer in a palliative care unit? J Palliat Med 13(12):1433–1438. https://doi.org/10.1089/jpm.2010.0240
Clark D (2002) Between hope and acceptance: the medicalisation of dying. BMJ 324(7342):905–907
Steinhauser KE, Clipp EC, McNeilly M, Christakis NA, McIntyre LM, Tulsky JA (2000) In search of a good death: observations of patients, families, and providers. Ann Intern Med 132(10):825–832
McNamara B, Waddell C, Colvin M (1994) The institutionalization of the good death. Soc Sci Med 39(11):1501–1508
Kehl KA (2006) Moving toward peace: an analysis of the concept of a good death. Am J Hosp Palliat Care 23(4):277–286. https://doi.org/10.1177/1049909106290380
Meier EA, Gallegos JV, Thomas LP, Depp CA, Irwin SA, Jeste DV (2016) Defining a good death (successful dying): literature review and a call for research and public dialogue. Am J Geriatr Psychiatry 24(4):261–271. https://doi.org/10.1016/j.jagp.2016.01.135
Miyashita M, Sanjo M, Morita T, Hirai K, Uchitomi Y (2007) Good death in cancer care: a nationwide quantitative study. Ann Oncol 18(6):1090–1097. https://doi.org/10.1093/annonc/mdm068
Granda-Cameron C, Houldin A (2012) Concept analysis of good death in terminally ill patients. Am J Hosp Palliat Care 29(8):632–639. https://doi.org/10.1177/1049909111434976
Steinhauser KE, Christakis NA, Clipp EC, McNeilly M, McIntyre L, Tulsky JA (2000) Factors considered important at the end of life by patients, family, physicians, and other care providers. JAMA 284(19):2476–2482
Levy PSLS (1965) Sampling. Wiley, New York
Yun Y, Rhee Y, Nam S, Chae Y, Heo D, Lee S, Hong Y, Kim S, Lee K (2004) Public attitudes toward dying with dignity and hospice. Korean journal of hospice and. Palliat Care 7(1):17–18
Association KM (2015) Annual Report Membership Statistics Korean Medical Association
Javier FO, Irawan C, Mansor MB, Sriraj W, Tan KH, Thinh DHQ (2016) Cancer pain management insights and reality in Southeast Asia: expert perspectives from six countries. J Glob Oncol 2(4):235–243. https://doi.org/10.1200/jgo.2015.001859
Hong SH, Roh SY, Kim SY, Shin SW, Kim CS, Choi JH, Kim SY, Yim CY, Sohn CH, Song HS, Hong YS (2011) Change in cancer pain management in Korea between 2001 and 2006: results of two nationwide surveys. J Pain Symptom Manag 41(1):93–103. https://doi.org/10.1016/j.jpainsymman.2010.03.025
Kastbom L, Milberg A, Karlsson M (2017) A good death from the perspective of palliative cancer patients. Support Care Cancer 25(3):933–939. https://doi.org/10.1007/s00520-016-3483-9
Funding
This research was supported by a grant from the Korea Health Technology R&D Project through the Korea Health Industry Development Institute (KHIDI), funded by the Ministry of Health & Welfare, Republic of Korea (grant number: HC15C1391) and Seokchun Daewoong Foundation (grant number: 80020160249). The funding agreement ensured the authors’ independence in designing the study, interpreting the data, writing, and publishing the report.
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All procedures in this study were performed in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or with comparable ethical standards. All participants provided written informed consent except for the general population, and the study was approved by the institutional review board of each hospital (IRB number: E-1612-102-815).
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The authors declare that they have no conflicts of interest.
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Yun, Y.H., Kim, KN., Sim, JA. et al. Priorities of a “good death” according to cancer patients, their family caregivers, physicians, and the general population: a nationwide survey. Support Care Cancer 26, 3479–3488 (2018). https://doi.org/10.1007/s00520-018-4209-y
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DOI: https://doi.org/10.1007/s00520-018-4209-y