Factors influencing death at home in terminally ill cancer patients.
OBJECTIVE
The purpose of this study is to investigate factors affecting terminally ill cancer patients dying at home.


METHODS
Ninety-two terminally ill cancer patients who were receiving home medical care services and died between April 2005 and December 2006 were included in the study. The data included patients' and caregivers' demographic characteristics, disease-related information, place of death, and status of home care support. To identify the factors predicting the place of death, multivariate logistic regression analyses were performed.


RESULTS
Patients of families who had no preference regarding the place of death or a preference for death at home were more likely to die at home (vs preference for hospital death, odds ratio = 5.87, 95% confidence interval = 1.02-36.53; odds ratio = 90.35, 95% confidence interval = 8.15-1001.51, respectively) after adjusting for potential confounders. Meanwhile, if the patient's family preferred that the patient not die at home, the patient's place of death was not at his/her home irrespective of his/her preference.


CONCLUSIONS
The results suggested the stronger involvement of families' preferences regarding the patients' place of death over patients' own preferences. Therefore, factors affecting families' preferences need to be clarified for the dissemination of death at home for terminally ill cancer patients.
Nakamura
Shunsuke
S
Department of Home Care Management, Nagoya University Graduate School of Medicine, Nagoya University School of Medicine, Nagoya, Japan. shunsuke2001@pop16.odn.ne.jp
Kuzuya
Masafumi
M
Funaki
Yoshimasa
Y
Matsui
Wataru
W
Ishiguro
Naoki
N
D032722:Advance Care Planning; D000368:Aged; D000369:Aged, 80 and over; D001293:Attitude to Death; D005190:Family; D005260:Female; D006699:Home Care Services / Q000706:statistics & numerical data*; D006801:Humans; D007407:Interviews as Topic; D007564:Japan / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000628:therapy*; D016017:Odds Ratio; D057240:Patient Preference; D012189:Retrospective Studies; D013727:Terminal Care / Q000379:methods / Q000706:statistics & numerical data*; D019452:Terminally Ill / Q000523:psychology