title: Public priorities and preferences for end-of-life care in Namibia.
abstract: BACKGROUND
  Although quality end-of-life care provision is an international public health issue, the majority of evidence is not generated in low- and middle-income countries that bear a disproportionate burden of progressive illnesses.
  
  
  OBJECTIVE
  To identify the priorities and preferences of the Namibian public for end-of-life care.
  
  
  METHODS
  Using a cross-sectional study design, data were collected in the country's capital, Windhoek, from November to December 2010.
  
  
  RESULTS
  In total, 200 respondents were recruited. The mean age was 27 years (SD 7.5; range 18-69), with nearly all (n = 199; 99.5%) expressing a religious affiliation. Being in pain was reported as the most concerning of nine common end-of-life symptoms and problems (n = 52; 26.1%), and the most important care-related aspect was having as much information as wanted (n = 144; 72%). The majority (64%) would want their end-of-life care to focus on improving their quality of life rather than extending it, with 40% not wanting to know if they had limited time left to live. Hospital (n = 96; 48%) and home (n = 64; 32%) were the most preferred places of death. The most important end-of-life priority was keeping a positive attitude (n = 128; 64%). Having had a close relative or friend diagnosed with a serious illness was associated with a 2.3 increase in the odds of preference for a hospital death (odds ratio = 2.34, P = 0.009, 95% CI 1.23-4.47).
  
  
  CONCLUSIONS
  This study identified a number of areas that need to be pursued in future research to explore factors that may affect patient preferences and priorities in end-of-life care in Namibia.
authors.affiliation: HealthCare Chaplaincy, New York, New York, USA; African Palliative Care Association, Kampala, Uganda. Electronic address: richard2powell@yahoo.co.uk.
authors.forename: Richard A
authors.initials: RA
authors.lastname: Powell
authors.affiliation: African Palliative Care Association, Kampala, Uganda.
authors.forename: Eve
authors.initials: E
authors.lastname: Namisango
authors.affiliation: African Palliative Care Association, Kampala, Uganda.
authors.forename: Nancy
authors.initials: N
authors.lastname: Gikaara
authors.affiliation: African Palliative Care Association, Kampala, Uganda.
authors.forename: Sherperd
authors.initials: S
authors.lastname: Moyo
authors.affiliation: African Palliative Care Association, Kampala, Uganda; Open Society Foundations, New York, New York, USA.
authors.forename: Faith N
authors.initials: FN
authors.lastname: Mwangi-Powell
authors.affiliation: King's College London, Cicely Saunders Institute, Department of Palliative Care, Policy & Rehabilitation, London, United Kingdom.
authors.forename: Barbara
authors.initials: B
authors.lastname: Gomes
authors.affiliation: King's College London, Cicely Saunders Institute, Department of Palliative Care, Policy & Rehabilitation, London, United Kingdom.
authors.forename: Richard
authors.initials: R
authors.lastname: Harding
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001293:Attitude to Death; D003430:Cross-Sectional Studies; D003657:Decision Making; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D008875:Middle Aged; D009276:Namibia; D010166:Palliative Care / Q000523:psychology; D057240:Patient Preference; D012959:Socioeconomic Factors; D013727:Terminal Care / Q000523:psychology*; D055815:Young Adult
keywords: Africa; Namibia; cancer; end of life; terminal