Preferencias del lugar donde morir cuando se sufre cáncer en estado avanzado

Título: Preferences for place of death if faced with advanced cancer: a population survey in England, Flanders, Germany, Italy, the Netherlands, Portugal and Spain.

Resumen:

Cancer end-of-life care (EoLC) policies assume people want to die at home. We aimed to examine variations in preferences for place of death cross-nationally.A telephone survey of a random sample of individuals aged >= 16 in England, Flanders, Germany, Italy, the Netherlands, Portugal and Spain. We determined where people would prefer to die if they had a serious illness such as advanced cancer, facilitating circumstances, personal values and experiences of illness, death and dying.

Of 9344 participants, between 51% (95% CI: 48% to 54%) in Portugal and 84% (95% CI: 82% to 86%) in the Netherlands would prefer to die at home. Cross-national analysis found there to be an influence of circumstances and values but not of experiences of illness, death and dying. Four factors were associated with a preference for home death in more than one country: younger age up to 70+ (Germany, the Netherlands, Portugal, Spain), increased importance of dying in the preferred place (England, Germany, Portugal, Spain), prioritizing keeping a positive attitude (Germany, Spain) and wanting to involve family in decisions if incapable (Flanders, Portugal). At least two-thirds of people prefer a home death in all but one country studied. The strong association with personal values suggests keeping home care at the heart of cancer EoLC.

Autores: Gomes, B (Gomes, B.), Higginson, IJ (Higginson, I. J.); Calanzani, N (Calanzani, N.); Cohen, J (Cohen, J.); Deliens, L (Deliens, L.); Daveson, BA (Daveson, B. A.); Bechinger-English, D (Bechinger-English, D.); Bausewein, C (Bausewein, C.); Ferreira, PL (Ferreira, P. L.); Toscani, F (Toscani, F.); Menaca, A (Menaca, A.); Gysels, M (Gysels, M.); Ceulemans, L (Ceulemans, L.); Simon, ST (Simon, S. T.); Pasman, HRW (Pasman, H. R. W.); Albers, G (Albers, G.); Hall, S (Hall, S.); Murtagh, FEM (Murtagh, F. E. M.); Haugen, DF (Haugen, D. F.); Downing, J (Downing, J.); Koffman, J (Koffman, J.); Pettenati, F (Pettenati, F.); Finetti, S (Finetti, S.); Antunes, B (Antunes, B.); On, RH (On, R. Harding)

Direcciones:

1. Kings College Londres, Reino Unido

2. Universidad de Gante, Bruselas, Bélgica

3. Universidad de Ámsterdam, Holanda

4. Asociación alemana de Medicina Paliativa, Berlín, Alemania