Study On Good Death

ObjectivesFind out the current situation of people's expectation of good death under the background of Chinese culture. Analyze the difference of different people's awareness and demand to good death. Explore the impact factor of the expectation of good death. To provide a theoretical basis for improving the quality of dying life and promoting services of Hospice Care.MethodsBased on literature review and focus groups, the research had established the Survey questionnaire of the expectation of Hospice Care. Using Convenient Sampling, 750 nursing interns, medical stuff and general population had been investigated in Third Grade Class General Hospital in Hubei, Beijing, Shanghai. The data was recorded with software EpiData3.1, double-entry method and analyzed with SPSS15.0 software. Analysis included general statistic descriptive analysis, Wilcoxon test or Kruskal-Wallis test, single-factor Logistic Regression Analysis, Multi-factors Non-condition Logistic Regression Analysis, Factor Analysis and Correspondence Analysis, etc. All tests were double-tailed tests and it indicates a statistic significance whenр<0.05.Results1 Nursing interns considered that the most three important factors were"the support of family"which had agreed rate 93.0% (4.4),"seeing the desired person"92.5% (4.34),"harmony with nurse"4.01. However, the agreed rate of"no pain"was 69.9% (3.72),"no medical instruments or tubes"51.6% (3.52). Experience of death disposal, history of caring critical ill patient, education, household location, experience of bereavement were predictors of nursing interns'expectation of good death (P<0.05 or P<0.01).2 Medical stuff considered that the agreed rate of"no pain"was 95.7% (4.33), the disagreed rate of"no over treatment","natural death"was only 5.9% (3.82) and 3.4% (3.99). Experience of serious illness, history of caring critical ill patient, department, occupation and gender were predictors of medical stuffs'expectation of good death (P<0.05 or P<0.01).3 General population considered that the agreed rate of"no medical instruments or tubes"and"no over treatment"were 50.5% (3.47), 60.5% (3.63); the agreed rate of"awareness of expected life span"and"awareness of one's life expectancy"were 55.3% (3.54), 60.5% (3.65). Experience of serious illness, history of caring critical ill patient, education, age and household location were predictors of general populations'expectation of good death (P<0.05 or P<0.01).4 Nursing interns, medical stuff and general population considered that"being respected","environmental comfort","good relationship with family","good relationship with medical stuff","independence","maintaining hope and pleasure"of core domain were the important factor, and the scores were all over 4. However, the score of"life purpose completion"was below 4.5 Nursing interns, medical stuff and general population considered that the score of"preparation for death"which included"seeing desired person","thanks for people around","saying out their own need"were over 4.Conclusions1 Nursing interns pay more attention on psychology and social need, but have few attention on physiology need. Medical college should pay attention to death education and guide students to think over the life thoroughly.2 Medical stuff advocate natural life, not blindly prolong patient's life meaninglessly. They think that we should relieve the family's burden and make rational use of public health resources.3 Developing scientific death-education according to different people and their general tendency is the groping ways to enhance medical staff's cognition of the view to life and death.4 Pay more attention on general population's death education and encourage them to establish correct and scientific view of death.5 The expectation of good death is mainly in good relationship with family and medical stuff, optimistic attitude, no pain, dignity, calm, independent and dying in a favorite place.