Hospice Care Preferences and Its Associated Factors among Community-Dwelling Residents in China
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Design and Sample
2.2. Data Collection
2.3. Measures
2.4. Data Analysis
3. Results
3.1. Characteristics of the Participants
3.2. Awareness of and Preference for Hospice Care and LST
3.3. Factors Related to Hospice Care Preference
4. Discussion
4.1. Preference for Hospice Care among Community-Dwelling Residents
4.2. Associated Factors Related to Hospice Care Preference among Community-Dwelling Residents
4.3. Strengths and Limitations of the Study
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Variables | Category | n (%) |
---|---|---|
Age (years) * | 18–29 | 55 (5.5) |
30–39 | 197 (19.9) | |
40–49 | 316 (31.9) | |
50–59 | 231 (23.3) | |
60+ | 193 (19.4) | |
Gender | Male | 330 (33.3) |
Female | 662 (66.7) | |
Educational level | Secondary school education and below | 318 (32.1) |
Bachelor’s degree or above | 674 (67.9) | |
Religious beliefs | None | 896 (90.3) |
Buddhism | 72 (7.3) | |
Christianity | 12 (1.2) | |
Others | 12 (1.2) | |
Marital status | Married/cohabited | 853 (86.0) |
Unmarried/divorced/separated/widowed | 139 (14.0) | |
Type of housing | Public apartment | 81 (8.2) |
Private housing | 809 (81.6) | |
Others | 102 (10.2) | |
Occupation | Student | 3 (0.3) |
Medical-related occupation | 69 (7.0) | |
Non-medical related occupation | 920 (92.7) | |
Financial status | Not adequate | 160 (16.1) |
Somewhat adequate | 443 (44.7) | |
Adequate | 389 (39.2) | |
Health insurance | Insured | 673(67.8) |
Uninsured | 319 (32.2) | |
Type of health insurance a | Free medical service | 303 (45.0) |
Commercial insurance | 251 (37.3) | |
Others | 119 (17.7) | |
Have a government subsidy | No/not clear | 765 (77.1) |
Yes | 227 (22.9) | |
Breadwinner of the family | Self | 465 (46.9) |
Spouse | 411 (41.4) | |
Others (sons/daughters, parents, government) | 116 (11.7) | |
Self-rated health | Good | 388 (39.1) |
Fair | 536 (54.0) | |
Poor | 68 (6.9) | |
Have chronic diseases | Yes | 251 (25.3) |
No | 555 (55.9) | |
Not clear | 186 (18.8) | |
Have a terminal illness | Yes | 16 (1.6) |
No | 874 (88.1) | |
Not clear | 102 (10.3) | |
Experience caring for family members with chronic diseases | No family member with chronic diseases | 527 (53.1) |
I was/am not the caregiver | 241 (24.3) | |
I was/am the caregiver | 224 (22.6) | |
Experience caring for family members with a terminal illness | No family member with a terminal illness | 847 (85.4) |
I was/am not the caregiver | 77 (7.8) | |
I was/am the caregiver | 68 (6.8) |
Variables | Category | n (%) |
---|---|---|
Heard of hospice care | Yes | 279 (28.1) |
No | 713 (71.9) | |
If you were diagnosed with a terminal illness, would you like to accept hospice care? | Yes, I want hospice care to give me comfort even if it cannot prolong my life | 905 (91.2) |
No, I want active LST to prolong my life as much as possible even it brings pain and discomfort | 87 (8.8) | |
Heard of LST, an active medical therapy, which has the potential to postpone patients’ death, but cannot recover health and would bring pain or discomfort | Yes | 623 (62.8) |
No | 369 (37.2) | |
If you were in a severe condition in which LST (e.g., mechanical ventilation, feeding tube) could not recover your health, and you might even have to rely on it in the long term to prolong your life, would you like to accept it? | Yes | 110 (11.1) |
No | 882 (88.9) | |
Reasons for accepting LST (may choose more than one answer) * | I couldn’t bear to leave my family | 74 (67.3) |
Try if there is a chance | 38 (34.5) | |
I want to live longer | 33 (30.0) | |
Others | 10 (9.2) | |
Reasons for rejecting LST (may choose more than one answer) a | To avoid of burdening the family | 628 (71.2) |
The treatments are too painful | 568 (64.4) | |
The effects of treatments are too limited | 480 (54.4) | |
Too many sequelae from treatments | 218 (24.7) | |
I’ve lived long enough | 36 (4.1) | |
Others | 56 (6.2) |
Variables | Category | Hospice Care Preference | Total (%) (n = 992) | χ2 | p | |
---|---|---|---|---|---|---|
Accept (%) (n = 905) | Reject (%) (n = 87) | |||||
Age | 18–29 | 48 (87.3) | 7 (12.7) | 55 (5.5) | 12.683 | 0.013 * |
30–39 | 178 (90.4) | 19 (9.6) | 197 (19.9) | |||
40–49 | 279 (88.3) | 37 (11.7) | 316 (31.9) | |||
50–59 | 213 (92.2) | 18 (7.8) | 231 (23.3) | |||
60+ | 187 (96.9) | 6 (3.1) | 193 (19.4) | |||
Gender | Male | 311 (94.2) | 19 (5.8) | 330 (33.3) | 5.609 | 0.011 * |
Female | 594 (89.7) | 68 (10.3) | 662 (66.7) | |||
Educational level | Secondary school education and below | 294 (92.5) | 24 (7.5) | 318 (32.1) | 14.873 | <0.001 * |
Bachelor’s degree or above | 611 (90.7) | 63 (9.3) | 674 (67.9) | |||
Religious belief | None | 817 (91.2) | 79 (8.8) | 896 (90.3) | 29.883 | <0.001 * |
Buddhism | 70 (97.2) | 2 (2.8) | 72 (7.3) | |||
Christianity | 6 (50.0) | 6 (50.0) | 12 (1.2) | |||
Others | 12 (100.0) | 0 (0) | 12 (1.2) | |||
Marital status | Married/cohabited | 773 (90.6) | 80 (9.4) | 853 (86.0) | 4.817 | 0.023 * |
Unmarried/divorced/separated/widowed | 132 (95.0) | 7 (5.0) | 139 (14.0) | |||
Type of housing | Public apartment | 78 (96.3) | 3 (3.7) | 81 (8.2) | 8.563 | 0.306 |
Private housing | 728 (90.0) | 81 (10.0) | 809 (81.6) | |||
Others | 99 (97.1) | 3 (2.9) | 102 (10.2) | |||
Occupation | Student | 3 (100) | 0 (0) | 3 (0.3) | 0.458 | 0.795 |
Medical-related occupation | 62 (89.9) | 7 (10.1) | 69 (7.0) | |||
Non-medical related occupation | 840 (91.3) | 80 (8.7) | 920 (92.7) | |||
Financial status | Not adequate | 155 (96.9) | 5 (3.1) | 160 (16.1) | 8.909 | 0.012 * |
Somewhat adequate | 404 (91.2) | 39 (8.8) | 443 (44.7) | |||
Adequate | 346 (88.9) | 43 (11.1) | 389 (39.2) | |||
Health insurance | Insured | 624 (92.7) | 49 (7.3) | 673(67.8) | 5.802 | 0.016 * |
Uninsured | 281 (88.1) | 38 (11.9) | 319 (32.2) | |||
Type of health insurance a | Free medical service | 282 (93.1) | 21 (6.9) | 303 (45.0) | 4.293 | 0.232 |
Commercial insurance | 233 (92.8) | 18 (7.2) | 251 (37.3) | |||
Others | 109 (91.6) | 10 (8.4) | 119 (17.7) | |||
Have a government subsidy | No/not clear | 687 (89.8) | 78 (10.2) | 765 (77.1) | 21.998 | 0.003 * |
Yes | 218 (96.0) | 9 (4.0) | 227 (22.9) | |||
Breadwinner of the family | Self | 426 (91.6) | 39 (8.4) | 465 (46.9) | 4.440 | 0.109 |
Spouse | 368 (89.5) | 43 (10.5) | 411 (41.4) | |||
Others (sons/daughters, parents, government) | 111 (95.7) | 5 (4.3) | 116 (11.7) | |||
Self-rated health | Good | 352 (90.7) | 36 (9.3) | 388 (39.1) | 11.117 | 0.004 * |
Fair | 498 (92.9) | 38 (7.1) | 536 (54.0) | |||
Poor | 55 (80.9) | 13 (19.1) | 68 (6.9) | |||
Have chronic diseases | Yes | 235 (93.6) | 16 (6.4) | 251 (25.3) | 3.316 | 0.190 |
No | 505 (91.0) | 50 (9.0) | 555 (55.9) | |||
Not clear | 165 (88.7) | 21 (11.3) | 186 (18.8) | |||
Have a terminal illness | Yes | 10 (62.5) | 6 (37.5) | 16 (1.6) | 18.420 | <0.001 * |
No | 798 (91.3) | 76 (8.7) | 874 (88.1) | |||
Not clear | 97 (95.1) | 5 (4.9) | 102 (10.3) | |||
Experience caring for family members with chronic diseases | No family member with chronic diseases | 474 (89.9) | 53 (10.1) | 527 (53.1) | 5.441 | 0.066 |
I was/am not the caregiver | 218 (90.5) | 23 (9.5) | 241 (24.3) | |||
I was/am the caregiver | 213 (95.1) | 11 (4.9) | 224 (22.6) | |||
Experience caring for family members with a terminal illness | No family member with a terminal illness | 770 (90.9) | 77 (9.1) | 847 (85.4) | 0.910 | 0.635 |
I was/am not the caregiver | 71 (92.2) | 6 (7.8) | 77 (7.8) | |||
I was/am the caregiver | 64 (94.1) | 4 (5.9) | 68 (6.8) | |||
Heard of hospice care | Yes | 237 (84.9) | 42 (15.1) | 279 (28.1) | 112.076 | <0.001 * |
No | 343 (48.1) | 370 (51.9) | 713 (71.9) | |||
Heard of LST, an active medical therapy, which has the potential to postpone patients’ death, but cannot recover health and would bring pain or discomfort | Yes | 580 (93.1) | 43 (6.9) | 623 (62.8) | 7.305 | 0.005 * |
No | 325 (88.1) | 44 (11.9) | 369 (37.2) |
Independent Predictors (Reject vs. Accept) | OR | 95% CI | p | β (SE) |
---|---|---|---|---|
Heard of hospice care | ||||
No (reference) | 1 | |||
Yes | 5.837 | 4.057–8.398 | <0.001 * | 1.764 |
Educational level | ||||
Secondary school education and below (reference) | 1 | |||
Bachelor’s degree or above | 1.825 | 1.364–2.442 | <0.001 * | 0.602 |
Health insurance | ||||
Uninsured (reference) | 1 | |||
Insured | 1.610 | 1.204–2.153 | 0.001 * | 0.476 |
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Lin, H.; Ko, E.; Wu, B.; Ni, P. Hospice Care Preferences and Its Associated Factors among Community-Dwelling Residents in China. Int. J. Environ. Res. Public Health 2022, 19, 9197. https://doi.org/10.3390/ijerph19159197
Lin H, Ko E, Wu B, Ni P. Hospice Care Preferences and Its Associated Factors among Community-Dwelling Residents in China. International Journal of Environmental Research and Public Health. 2022; 19(15):9197. https://doi.org/10.3390/ijerph19159197
Chicago/Turabian StyleLin, Huijing, Eunjeong Ko, Bei Wu, and Ping Ni. 2022. "Hospice Care Preferences and Its Associated Factors among Community-Dwelling Residents in China" International Journal of Environmental Research and Public Health 19, no. 15: 9197. https://doi.org/10.3390/ijerph19159197